Individual
STACEY KAY WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5593 N GLENWOOD ST, GARDEN CITY, ID 83714
(208) 322-5354
(208) 322-5379
Mailing address
3810 E HARDESTY ST, BOISE, ID 83716-5595
(208) 631-0685
(208) 322-5379
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
813271
NV
363LF0000X
Family Nurse Practitioner
Primary
NP539A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806663602
—
ID
Enumeration date
03/30/2006
Last updated
03/07/2023
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