Individual
MISS STACY LYNN LIBRICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2946 E BANNER GATEWAY DR, GILBERT, AZ 85234-2165
(480) 256-6444
(480) 256-3682
Mailing address
2946 E BANNER GATEWAY DR, GILBERT, AZ 85234-2165
(480) 256-6444
(480) 256-3682
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
001397-1
NY
363AM0700X
Medical Physician Assistant
Primary
4513
AZ
Other
Enumeration date
01/11/2007
Last updated
07/20/2022
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