Stacey Eckenrod

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

271623 Issued in AZ

Practice address

1845 Campbell Ave
Prescott, AZ 86301-1211

Phone

(928) 717-3276

NPI assigned

Aug 3, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1053093567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E GURLEY ST # 200",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863013804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 CAMPBELL AVE",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011211",
            "telephone_number": "928-717-3276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKENROD",
        "first_name": "STACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "AZ",
            "license": "271623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Herta Dwyer, NP
• E Hospice Group of Arizona No 1 LLC
• E Z Sleep Lab LLC
• Kevin D Earnst
• Lois Marie Eaton, NMD
• Ronael Eckman, MD
• Courtney Edel, PHARMD
• Eden Hospice Care Inc
• Desiree Nicole Eden
• Gail L Edgerton, LCSW

• School Registered Nurse in Prescott, AZ
• Providers in Prescott, AZ by specialty
• School Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.