Provider Demographics
NPI:1023310349
Name:STUBBS, MARLY R (FNP)
Entity type:Individual
Prefix:MRS
First Name:MARLY
Middle Name:R
Last Name:STUBBS
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 1:617 PYRAMID WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-5060
Mailing Address - Country:US
Mailing Address - Phone:775-200-6905
Mailing Address - Fax:
Practice Address - Street 1:650 FERRARI MCLEOD BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-1060
Practice Address - Country:US
Practice Address - Phone:775-328-7888
Practice Address - Fax:775-325-7933
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV814167363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily