Provider Demographics
NPI:1477379121
Name:THORNLEY, STACY (FNP)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:THORNLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:743 MILLER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-1813
Mailing Address - Country:US
Mailing Address - Phone:928-777-9600
Mailing Address - Fax:855-449-5560
Practice Address - Street 1:743 MILLER VALLEY RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1813
Practice Address - Country:US
Practice Address - Phone:928-777-9600
Practice Address - Fax:855-449-5560
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2025-06-05
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Provider Licenses
StateLicense IDTaxonomies
AZ3176822085R0204X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology