Healthcare Provider Details

I. General information

NPI: 1528990983
Provider Name (Legal Business Name): PAIGE LAUREN STOVER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 SUNSET AVE
MANHATTAN KS
66502-3739
US

IV. Provider business mailing address

707 S 3RD ST
HIAWATHA KS
66434-2716
US

V. Phone/Fax

Practice location:
  • Phone: 785-532-5568
  • Fax:
Mailing address:
  • Phone: 785-288-8545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: