Provider Demographics
NPI:1265866016
Name:STAHL, SHELBY
Entity Type:Individual
Prefix:MS
First Name:SHELBY
Middle Name:
Last Name:STAHL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 TANNER DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-3057
Mailing Address - Country:US
Mailing Address - Phone:972-420-6785
Mailing Address - Fax:
Practice Address - Street 1:1233 TANNER DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-3057
Practice Address - Country:US
Practice Address - Phone:972-420-6785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion