Healthcare Provider Details

I. General information

NPI: 1396615019
Provider Name (Legal Business Name): THE GOLDEN RULE FAMILY NURSE PRACTICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25787 W GIBSON LN
BUCKEYE AZ
85326-9172
US

IV. Provider business mailing address

25787 W GIBSON LN
BUCKEYE AZ
85326-9172
US

V. Phone/Fax

Practice location:
  • Phone: 623-202-4606
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STACY L MANES
Title or Position: FAMILY NURSE PRACTITIONER
Credential:
Phone: 623-202-4606