Individual
STACEE LYDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
2222 N CRAYCROFT RD STE 150, TUCSON, AZ 85712-2816
(520) 202-3488
(520) 202-3486
Mailing address
5055 E BROADWAY BLVD STE A100, TUCSON, AZ 85711-3629
(520) 382-1085
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
228942
AZ
Other
Enumeration date
11/05/2019
Last updated
08/06/2020
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