Nellis, Stacie Lynn

Nellis, Stacie Lynn is an individual health care provider with primary practice located at 80495 Us Highway 111 , Indio CA 92201-6534. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Nellis, Stacie Lynn can be contacted via phone (760) 347-2887.

Contact Information

Primary practice address
80495 Us Highway 111 Indio CA 92201-6534
Phone: (760) 347-2887
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP16463 California

Profile Details

NPI number 1285720250
LBN Legal business name Nellis, Stacie Lynn
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2006
Last updated Apr 16th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285720250 NPPES
California MEDICAID 1285720250

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