Provider Demographics
NPI:1659478238
Name:ADAMS, SALLY STADLER (MS, RN, CPNP)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:STADLER
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MS, RN, CPNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13980 FAR HILLS LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-3739
Mailing Address - Country:US
Mailing Address - Phone:972-960-1473
Mailing Address - Fax:214-456-5702
Practice Address - Street 1:1935 MOTOR ST
Practice Address - Street 2:LOW BIRTH WEIGHT CLINIC/ARCH CENTER
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-2132
Practice Address - Fax:214-456-5702
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX4-42375363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics