Provider Demographics
NPI:1275141988
Name:HEMINGWAY, STELLA JEAN
Entity Type:Individual
Prefix:MS
First Name:STELLA
Middle Name:JEAN
Last Name:HEMINGWAY
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 1:1909 S ALEX RD
Mailing Address - Street 2:
Mailing Address - City:WEST CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-4001
Mailing Address - Country:US
Mailing Address - Phone:614-364-0429
Mailing Address - Fax:
Practice Address - Street 1:1909 S ALEX RD
Practice Address - Street 2:
Practice Address - City:WEST CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:45449-4001
Practice Address - Country:US
Practice Address - Phone:614-364-0429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist