MEDICARE: STACEY LEIGH ADAMS ACNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	N0156911	TX
2	163W00000X	Registered Nurse	657277	TX
3	363LA2100X	Acute Care Nurse Practitioner	N0156911	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932377538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY LEIGH ADAMS ACNP

Provider Business Mailing Address
First Line	:	3051 N ZARAGOZA RD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-7921
Country	:	US
Telephone Number	:	915-401-8019
Fax Number	:	915-401-8096

Provider Business Practice Location Address
First Line	:	1618 N LEE TREVINO DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-5104
Country	:	US
Telephone Number	:	915-990-1345
Fax Number	:	915-990-1350

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	01/29/2026

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