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NPI Code Detail

MEDICARE: MRS. TAMMIE ANN STAHL CRNA

MEDICARE: MRS. TAMMIE ANN STAHL CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistAPN1020SC
2367500000XCertified Registered Nurse Anesthetist4220NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033111505
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TAMMIE ANN STAHL CRNA
Provider Business Mailing Address
First Line : 408 MENDENHALL ST
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-5226
Country : US
Telephone Number : 184-382-1867
Fax Number : 184-340-2183
Provider Business Practice Location Address
First Line : 2095 HENRY TECKLENBURG DR
Second Line :
City : CHARLESTON
State : SC
Zip : 29414-5733
Country : US
Telephone Number : 843-402-1436
Fax Number : 843-402-1833
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2005
Last Update Date : 03/17/2023

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