Individual
STACEY WAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2013 W MINNEZONA AVE, PHOENIX, AZ 85015-4157
(408) 559-7387
Mailing address
2013 W MINNEZONA AVE, PHOENIX, AZ 85015-4157
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2000703800
AZ
Other
Enumeration date
05/27/2026
Last updated
05/27/2026
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