Provider Demographics
NPI:1073836276
Name:DOOLEY, STACI ANN (MSN, APN)
Entity Type:Individual
Prefix:
First Name:STACI
Middle Name:ANN
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:MSN, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10415 DOUBLE R BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-8905
Mailing Address - Country:US
Mailing Address - Phone:775-829-2277
Mailing Address - Fax:775-829-2365
Practice Address - Street 1:15 MCCABE DR STE 200
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-4816
Practice Address - Country:US
Practice Address - Phone:775-204-4000
Practice Address - Fax:775-204-4001
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001179363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily