Provider Demographics
NPI:1740686120
Name:STAHL, AIMEE KATHRYN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:KATHRYN
Last Name:STAHL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10767 E TRAVERSE HWY
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-6219
Mailing Address - Country:US
Mailing Address - Phone:231-947-0351
Mailing Address - Fax:
Practice Address - Street 1:10767 E TRAVERSE HWY
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-6219
Practice Address - Country:US
Practice Address - Phone:231-947-0351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-12
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704272614363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily