Provider Demographics
NPI:1467671842
Name:STUMPF, DIANNE FAYE (NP)
Entity Type:Individual
Prefix:MRS
First Name:DIANNE
Middle Name:FAYE
Last Name:STUMPF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4005 MILLSBORO RD W
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-8788
Mailing Address - Country:US
Mailing Address - Phone:419-529-4519
Mailing Address - Fax:419-289-5209
Practice Address - Street 1:ASHLAND UNIVERSITY
Practice Address - Street 2:401 COLLEGE AVE.
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805
Practice Address - Country:US
Practice Address - Phone:419-289-5201
Practice Address - Fax:419-289-5209
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP02672363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health