Provider Demographics
NPI:1942787213
Name:STAPELMANN, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:STAPELMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 ELKWOOD SECTION RD
Mailing Address - Street 2:
Mailing Address - City:HAZEL GREEN
Mailing Address - State:AL
Mailing Address - Zip Code:35750-9420
Mailing Address - Country:US
Mailing Address - Phone:256-693-9451
Mailing Address - Fax:256-801-7896
Practice Address - Street 1:158 ELKWOOD SECTION RD
Practice Address - Street 2:
Practice Address - City:HAZEL GREEN
Practice Address - State:AL
Practice Address - Zip Code:35750
Practice Address - Country:US
Practice Address - Phone:256-693-9451
Practice Address - Fax:256-801-7896
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3765133V00000X
AL3050133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2107333Medicaid