Healthcare Provider Details

I. General information

NPI: 1245701085
Provider Name (Legal Business Name): STINSON MOBILE AUD DE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 12/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 LITTLE FALLS DR
WILMINGTON DE
19808-1674
US

IV. Provider business mailing address

12910 SHELBYVILLE RD STE 300
LOUISVILLE KY
40243-2404
US

V. Phone/Fax

Practice location:
  • Phone: 502-244-2441
  • Fax: 502-254-4069
Mailing address:
  • Phone: 502-244-2441
  • Fax: 502-244-2441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER STINSON
Title or Position: OWNER
Credential: AUD
Phone: 502-244-2441