Provider Demographics
NPI:1710317029
Name:STAHL, ALESHIA A (APRN)
Entity Type:Individual
Prefix:MS
First Name:ALESHIA
Middle Name:A
Last Name:STAHL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ALESHIA
Other - Middle Name:A
Other - Last Name:ROUSSEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1 CELLINI PL STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-1666
Mailing Address - Country:US
Mailing Address - Phone:203-932-6481
Mailing Address - Fax:203-932-4051
Practice Address - Street 1:1 CELLINI PL STE 102
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-1666
Practice Address - Country:US
Practice Address - Phone:203-932-6481
Practice Address - Fax:203-932-4051
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005600363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health