Provider Demographics
NPI:1194028696
Name:STACHLER, PAMELA JOYCE (APRN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JOYCE
Last Name:STACHLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 MYERS RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-9702
Mailing Address - Country:US
Mailing Address - Phone:317-718-8436
Mailing Address - Fax:317-718-8438
Practice Address - Street 1:202 MYERS RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-9702
Practice Address - Country:US
Practice Address - Phone:317-718-8436
Practice Address - Fax:317-718-8438
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003424B364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent