STACEE LYDERS CPNP-PC NPI 1548804206

NPI Information

  • NPI: 1548804206
  • Provider Name: STACEE LYDERS, CPNP-PC
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2222 N CRAYCROFT RD STE 150
    TUCSON, AZ
    ZIP 85712
  • Phone: (520) 202-3488

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NPI Details

Stacee Lyders, CPNP-PC is a pediatrics nurse practitioner in Tucson, AZ. Stacee Lyders, CPNP-PC NPI is 1548804206. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2222 N CRAYCROFT RD STE 150
TUCSON, AZ
ZIP 85712-816
Phone: (520) 202-3488
Fax: (520) 202-3486

The NPI 1548804206 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/5/2019 and was last updated on 8/6/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatrics228942ARIZONAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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