Provider Demographics
NPI:1508134453
Name:STEHLIK, KATHY M (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:M
Last Name:STEHLIK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 RUSHMORE AVE
Mailing Address - Street 2:
Mailing Address - City:CARLE PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11514-1448
Mailing Address - Country:US
Mailing Address - Phone:516-622-6423
Mailing Address - Fax:516-622-6588
Practice Address - Street 1:251 RUSHMORE AVE
Practice Address - Street 2:
Practice Address - City:CARLE PLACE
Practice Address - State:NY
Practice Address - Zip Code:11514-1448
Practice Address - Country:US
Practice Address - Phone:516-622-6423
Practice Address - Fax:516-622-6588
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY576382163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool