| Doctor Name: | NICHOLAS SCOTT STAGG |
| NPI Number: | 1073917829 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP-C |
| License Number: | 5811750 |
| Business Practice Address: | 2585 Miracle Mile Bullhead City, AZ - 864427522 |
| Business Phone Number: | 9287041221 |
| Business Fax Number: | 9287041243 |
| Mailing Address: | 2585 Miracle Mile, BULLHEAD CITY |
| State: | AZ |
| Postal Code: | 864427522 |
| Phone Number: | 9287041221 |
| Fax Number: | 9287041243 |
| NPI Enumeration Date: | 10/22/2014 |
| NPI Last Update Date: | 04/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 5811750 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |