Individual
MS. JEANNE GAIL STAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM, FNP-C, MSN
Contact information
Practice address
3225 DYER ST, LAS CRUCES, NM 88011-4803
(575) 888-4067
(575) 888-4067
Mailing address
3225 DYER ST, LAS CRUCES, NM 88011-4803
(575) 888-4067
(575) 449-2425
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
59814
NM
367A00000X
Advanced Practice Midwife
Primary
725
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085311
—
OR
05
—
13552716
—
NM
05
—
47823071
—
NM
01
—
567052YRND
MEDICARE
NM
05
—
89076044
—
NM
05
—
9625898
—
WA
01
—
R176941
MEDICARE PTAN
OR
01
—
Z157796
MEDICARE PTAN
AZ
Enumeration date
03/04/2006
Last updated
12/07/2024
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