Provider Demographics
NPI:1396501912
Name:WOODS, STACEY (RN, CNM)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:
Other - Last Name:PICCINATI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CNM
Mailing Address - Street 1:11636 N SAINT ANDREWS WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4819
Mailing Address - Country:US
Mailing Address - Phone:646-342-4534
Mailing Address - Fax:
Practice Address - Street 1:11636 N SAINT ANDREWS WAY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4819
Practice Address - Country:US
Practice Address - Phone:646-342-4534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2794367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife