Provider Demographics
NPI:1710439773
Name:STAGER, LAURA ANNE (FNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANNE
Last Name:STAGER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 E MCMURRAY BLVD
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-5404
Mailing Address - Country:US
Mailing Address - Phone:520-374-6536
Mailing Address - Fax:520-374-6541
Practice Address - Street 1:1811 E MCMURRAY BLVD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5404
Practice Address - Country:US
Practice Address - Phone:520-374-6530
Practice Address - Fax:520-374-6541
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP9748363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily