Healthcare Provider Details

I. General information

NPI: 1851578777
Provider Name (Legal Business Name): DEANNE STAHELI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 01/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 S 900 E
ST GEORGE UT
84790-7000
US

IV. Provider business mailing address

2222 W 8900 N
DAMMERON VALLEY UT
84783-5201
US

V. Phone/Fax

Practice location:
  • Phone: 435-673-7003
  • Fax:
Mailing address:
  • Phone: 435-574-3552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number206603-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: