| Doctor Name: | STACY ALI |
| NPI Number: | 1255415451 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | AP3006906 |
| Business Practice Address: | Corner Or North 7 And North 12 Fort Defiance, AZ - 86504 |
| Business Phone Number: | 9287298000 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1077, FORT DEFIANCE |
| State: | AZ |
| Postal Code: | 865041077 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP3006906 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |