Individual
AMY STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4700 LAS VEGAS BLVD N BLDG 1300, NELLIS AFB, NV 89191-6600
(702) 653-2273
Mailing address
4700 LAS VEGAS BLVD N, LAS VEGAS, NV 89191-6600
(702) 653-2273
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34.013920
OH
207RC0000X
Cardiovascular Disease Physician
Primary
34.013920
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0379036
—
OH
Enumeration date
02/10/2016
Last updated
02/26/2025
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