Healthcare Provider Details

I. General information

NPI: 1467745844
Provider Name (Legal Business Name): HOLLY STAHLMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2011
Last Update Date: 05/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE
CINCINNATI OH
45229-3039
US

IV. Provider business mailing address

3333 BURNET AVE
CINCINNATI OH
45229-3039
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4225
  • Fax: 513-636-2511
Mailing address:
  • Phone: 513-636-4225
  • Fax: 513-636-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberCOA12270NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: