Provider Demographics
NPI:1659129120
Name:STAHELI, MICHAEL JAROM (DNP, FNP-C, APRN)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAROM
Last Name:STAHELI
Suffix:
Gender:M
Credentials:DNP, FNP-C, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9049 N SUFFOLK LN
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-4421
Mailing Address - Country:US
Mailing Address - Phone:435-406-4439
Mailing Address - Fax:
Practice Address - Street 1:9049 N SUFFOLK LN
Practice Address - Street 2:
Practice Address - City:EAGLE MOUNTAIN
Practice Address - State:UT
Practice Address - Zip Code:84005-4421
Practice Address - Country:US
Practice Address - Phone:435-406-4439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9517235-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily