Provider Demographics
NPI:1043705742
Name:STUCKEY, NAPOLEON
Entity Type:Individual
Prefix:
First Name:NAPOLEON
Middle Name:
Last Name:STUCKEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 W ANN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-3840
Mailing Address - Country:US
Mailing Address - Phone:702-550-6700
Mailing Address - Fax:702-550-4872
Practice Address - Street 1:3924 CARLA ANN RD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-4086
Practice Address - Country:US
Practice Address - Phone:702-629-7102
Practice Address - Fax:702-550-4872
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner