Individual
MICHELLE L. STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
270 W LAKE MEAD PKWY, HENDERSON, NV 89015-7093
(702) 877-5199
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 877-5199
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11436
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982627303
—
NV
Enumeration date
07/26/2006
Last updated
11/18/2024
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