Provider Demographics
NPI:1912017542
Name:STAPLETON, ANN M (DC)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:STAPLETON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 542
Mailing Address - Street 2:
Mailing Address - City:MILLHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:16854-0542
Mailing Address - Country:US
Mailing Address - Phone:814-349-9806
Mailing Address - Fax:
Practice Address - Street 1:116 PENN ST.
Practice Address - Street 2:
Practice Address - City:MILLHEIM
Practice Address - State:PA
Practice Address - Zip Code:16854
Practice Address - Country:US
Practice Address - Phone:814-349-9806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-0042 13L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011883870002Medicaid
PA585013Medicare ID - Type Unspecified