Provider Demographics
NPI:1649878315
Name:STOEPPEL, TINA MAY
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:MAY
Last Name:STOEPPEL
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 1:7110 CINCINNATI BROOKVILLE RD
Mailing Address - Street 2:
Mailing Address - City:OKEANA
Mailing Address - State:OH
Mailing Address - Zip Code:45053-9541
Mailing Address - Country:US
Mailing Address - Phone:513-739-4970
Mailing Address - Fax:
Practice Address - Street 1:7110 CINCINNATI BROOKVILLE RD
Practice Address - Street 2:
Practice Address - City:OKEANA
Practice Address - State:OH
Practice Address - Zip Code:45053-9541
Practice Address - Country:US
Practice Address - Phone:513-739-4970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle