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Sallye Louise Stauber

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

921 W Owens Ave Ste 150, Las Vegas, NV 89106-5405

PECOS Enrollment

This provider is enrolled in PECOS as SALLYE STAUBER.

Based on the most recent information from CMS, provider Sallye Louise Stauber is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1235174806
Provider Type
Individual
Full Name
Stauber, Sallye Louise
Title
Ms.
Credential
DNP, FNP-C

Gender
Female
Sole Proprietor
No
Enumeration Date
6/18/2006
Last Updated
2/1/2023

Contact Information

Practice Location

921 W Owens Ave Ste 150, Las Vegas, NV 89106-5405

(252) 693-3647

Unlisted Fax

Mailing Location

102 Woodmont Blvd Ste 600, Nashville, TN 37205-5250

(615) 314-8069

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 852947 Nevada
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 200150002NP Oregon

Sallye Louise Stauber

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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