Provider Demographics
NPI:1780079525
Name:STAHMER, HANNAH MARY (RD)
Entity type:Individual
Prefix:MISS
First Name:HANNAH
Middle Name:MARY
Last Name:STAHMER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 SW 16TH AVE
Mailing Address - Street 2:BUILDING A
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-1153
Mailing Address - Country:US
Mailing Address - Phone:352-334-1384
Mailing Address - Fax:
Practice Address - Street 1:1701 SW 16TH AVE
Practice Address - Street 2:BUILDING A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1153
Practice Address - Country:US
Practice Address - Phone:352-334-1384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND2182133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIE073ZMedicare PIN