Individual
MS. NANCY STALEY
Active
Individual
MS. NANCY STALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00286
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000027594
BCBS RI
RI
01
—
200286
CONNECTICARE
CT
01
—
290000286RI01
ANTHEM CT
RI
01
—
411588
BLUE CHIP RI
RI
05
—
9004837
—
RI
Enumeration date
04/09/2006
Last updated
03/25/2010
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