Individual
STACI VISTUBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
14929 S GALLERY ST, OLATHE, KS 66062-3338
(816) 509-4083
(913) 829-4547
Mailing address
14929 S GALLERY ST, OLATHE, KS 66062-3338
(816) 509-4083
(913) 829-4547
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
1378159121
KS
Other
Enumeration date
06/26/2008
Last updated
06/26/2008
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