Basic Information
| Provider Information | |||||||||
| NPI: | 1073836276 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOOLEY | ||||||||
| FirstName: | STACI | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | MSN, APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10415 DOUBLE R BLVD | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895218905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758292277 | ||||||||
| FaxNumber: | 7758292365 | ||||||||
| Practice Location | |||||||||
| Address1: | 15 MCCABE DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895114816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7752044000 | ||||||||
| FaxNumber: | 7752044001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2010 | ||||||||
| LastUpdateDate: | 03/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APN001179 | NV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.