Provider Demographics
NPI:1598053811
Name:HOADLEY, STASIA (LPN)
Entity Type:Individual
Prefix:
First Name:STASIA
Middle Name:
Last Name:HOADLEY
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 1:4 OAKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-7726
Mailing Address - Country:US
Mailing Address - Phone:716-602-4898
Mailing Address - Fax:
Practice Address - Street 1:4 OAKVIEW DR
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-7726
Practice Address - Country:US
Practice Address - Phone:716-602-4898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2013-11-26
Deactivation Date:2012-06-26
Deactivation Code:
Reactivation Date:2013-11-26
Provider Licenses
StateLicense IDTaxonomies
NY305693-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse