Individual
MRS. STACI ANN PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1200 W MOHAVE RD, PARKER, AZ 85344-6349
(928) 669-7380
(928) 669-7371
Mailing address
PO BOX 617, SOMERTON, AZ 85350-0617
(928) 315-7910
(928) 722-6113
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
6312
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144556
—
AZ
Enumeration date
02/22/2016
Last updated
08/13/2024
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