Carmella Renae Staley, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP033913 Issued in AZ

Practice address

1575 W Southern Ave
Apache Junction, AZ 85220-7456

Phone

(480) 982-1110

Fax

(480) 474-8370

NPI assigned

Feb 15, 2007

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

Other names 1

• Mrs. Carmella Renae Lancaster Former name

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063555191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 E MCDOWELL RD LOT 343",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151448",
            "telephone_number": "480-830-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 W SOUTHERN AVE",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "852207456",
            "telephone_number": "480-982-1110",
            "fax_number": "480-474-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALEY",
        "first_name": "CARMELLA",
        "middle_name": "RENAE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP033913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARMELLA",
            "last_name": "LANCASTER",
            "middle_name": "RENAE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Smiths Food & Drug Centers Inc (Frys Food and Drug)
• Paul Steven Sokolowski, AGACNP-BC
• Southwest Behavioral Health Services, Inc
• Southwestern Eye Center LTD (Southwestern Eye Center-Apache Junction)
• Sozo Health and Wellness Services, PLLC
• Star Therapy, Inc.
• David Stauffer
• Samantha Suzanne Steele-Godlewski
• Kathryn Ann Steidle, PT
• Troy Stevenson, PA

• Licensed Practical Nurse in Apache Junction, AZ
• Providers in Apache Junction, AZ by specialty
• Licensed Practical Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.