Stacie Dunn
Individual provider Active NPI Speech-Language Pathologist · Queen Creek, AZ
NPI 1720115082 · NPPES record last updated Mar 12, 2010
Key facts
- NPI
- 1720115082
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP2072 (AZ)
- Practice address
- 18816 E Arrowhead TRL
Queen Creek, AZ 85142-6848 - Phone
- (480) 390-1781
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP2072 | AZ | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP2072 | AZ | Yes |
Addresses
Primary practice location
18816 E Arrowhead TRL
Queen Creek, AZ 85142-6848
Mailing address
18816 E Arrowhead TRL
Queen Creek, AZ 85142-6848
Phone (480) 390-1781
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AZ0140920 | Other | AZ | BLUE CROSS BLUE SHIELD |
| 718968 | Medicaid | AZ |
NPI Registry JSON
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268352000000",
"number": "1720115082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18816 E ARROWHEAD TRL",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851426848",
"telephone_number": "480-390-1781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18816 E ARROWHEAD TRL",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851426848",
"telephone_number": "480-390-1781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNN",
"first_name": "STACIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2010-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "SLP2072",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "AZ0140920",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "718968",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Queen Creek, AZ
- Joshua Dorris
- Doug S Clouse MD PLC
- Douglas B Hunt PC
- Ducray Wellness, LLC
- Tyler Bianca Duford
- Margaret A Dusold
- Beth Duyck
- Katherine Dyament
- Yolanda E. Dye-Fernandez
- East Valley Endodontics
All providers in Queen Creek, AZ · Speech-Language Pathologist in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.