Provider Demographics
NPI:1568070480
Name:STIMAR HEALTHCARE LLC
Entity Type:Organization
Organization Name:STIMAR HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:AIYESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:STILES
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:502-873-6296
Mailing Address - Street 1:2111 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40210-1419
Mailing Address - Country:US
Mailing Address - Phone:502-873-6296
Mailing Address - Fax:
Practice Address - Street 1:2111 W OAK ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40210-1419
Practice Address - Country:US
Practice Address - Phone:502-873-6296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty