Provider Demographics
NPI:1972849529
Name:STAHL, STACY E (CRNP)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:E
Last Name:STAHL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 BEANER HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-9722
Mailing Address - Country:US
Mailing Address - Phone:724-774-0778
Mailing Address - Fax:724-774-1109
Practice Address - Street 1:1030 BEANER HOLLOW RD
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-9722
Practice Address - Country:US
Practice Address - Phone:724-774-0778
Practice Address - Fax:724-774-1109
Is Sole Proprietor?:No
Enumeration Date:2012-12-28
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012587363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily