Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Stacy Petersen

Individual provider Electroneurodiagnostic Specialist/Technologist · NPI 1063055150

Stacy Petersen is an Electroneurodiagnostic Specialist/Technologist in Las Vegas, Nevada. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

9811 W Charleston Blvd # 2-641
Las Vegas, NV 89117-7528
Phone: (855) 864-4322
Fax: (866) 540-8267
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Electroneurodiagnostic Specialist/Technologist (primary) Taxonomy 246ZE0600X

Record details

NPI number1063055150
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 22, 2019
Last updated in NPPESOctober 22, 2019
Mailing address1571 Plaza Centre Dr, Las Vegas, NV 89135-3408

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