Provider Demographics
NPI:1508934704
Name:THOMAS STAHL, CHERYL ANN (NEONATAL NURSE PRACT)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ANN
Last Name:THOMAS STAHL
Suffix:
Gender:F
Credentials:NEONATAL NURSE PRACT
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:9170 E SHOWCASE LANE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-9274
Mailing Address - Country:US
Mailing Address - Phone:520-749-6321
Mailing Address - Fax:
Practice Address - Street 1:5301 EAST GRANT ROAD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712
Practice Address - Country:US
Practice Address - Phone:520-324-5585
Practice Address - Fax:520-324-1848
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN056822363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN056822OtherAZ STATE BOARD OF NURSING