Individual
STACEY L LINCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1850 N CENTRAL AVE STE 1600, PHOENIX, AZ 85004-4633
(602) 262-8900
(602) 262-4132
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
(602) 470-5064
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2001016542
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA1221
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
910997501
—
MO
01
—
P00391447
RAILROAD MEDICARE
MO
Enumeration date
07/19/2006
Last updated
10/16/2017
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