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General NPI Number Information
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NPI Number | 1144978206
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Entity Type | Individual
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Provider Name | STACEY MARIE FERKIN
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Gender | Female
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 8687 BANDO DR
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City | LAS VEGAS
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State | NV
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Zip | 89148-5375
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Country | US
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Telephone | 262-909-2923
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Fax |
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Provider Business Mailing Address
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Address Line | 8687 BANDO DR
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City | LAS VEGAS
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State | NV
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Zip | 89148-5375
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Country | US
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Telephone | 262-909-2923
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 868193
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 163WX0003X
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Taxonomy Name | Inpatient Obstetric Registered Nurse
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License Number | RN85888
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License Number State | NV
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