Provider Demographics
NPI:1578791174
Name:STOFFA, EILEEN M (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:M
Last Name:STOFFA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121ST CSH
Mailing Address - Street 2:UNIT 15244
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205-5244
Mailing Address - Country:US
Mailing Address - Phone:011-737-4243
Mailing Address - Fax:011-737-5137
Practice Address - Street 1:121ST CSH
Practice Address - Street 2:UNIT 15244
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205-5244
Practice Address - Country:US
Practice Address - Phone:011-737-4243
Practice Address - Fax:011-737-5137
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN142828163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse