Individual
MS. STACY LYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
492 DANTE VILLA ST, HENDERSON, NV 89011-5689
(208) 251-2524
Mailing address
492 DANTE VILLA ST, HENDERSON, NV 89011-5689
(208) 251-2524
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN002018
NV
363LF0000X
Family Nurse Practitioner
NP-935A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992030928
—
NV
Enumeration date
10/08/2009
Last updated
09/01/2025
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