Provider Demographics
NPI:1255916920
Name:STALNAKER, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:STALNAKER
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 1:163 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:WV
Mailing Address - Zip Code:25064-3201
Mailing Address - Country:US
Mailing Address - Phone:304-415-7933
Mailing Address - Fax:
Practice Address - Street 1:163 4TH ST
Practice Address - Street 2:
Practice Address - City:DUNBAR
Practice Address - State:WV
Practice Address - Zip Code:25064-3201
Practice Address - Country:US
Practice Address - Phone:304-415-7933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker