Provider Demographics
NPI:1497012108
Name:STUMP, NAMIE ELIZABETH (LPN)
Entity Type:Individual
Prefix:MS
First Name:NAMIE
Middle Name:ELIZABETH
Last Name:STUMP
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 HITE ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25702-2118
Mailing Address - Country:US
Mailing Address - Phone:304-412-4831
Mailing Address - Fax:
Practice Address - Street 1:555 HITE ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-2118
Practice Address - Country:US
Practice Address - Phone:304-412-4831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV30570164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse