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General NPI Number Information
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NPI Number | 1083889893
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Entity Type | Organization
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Legal Business Name | RIVERSIDE HEALTH CENTER, LLC
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 819 N MILLER ST SUITE 1B
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City | WENATCHEE
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State | WA
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Zip | 98801-6604
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Country | US
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Telephone | 509-888-1924
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Fax | 509-888-2238
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Provider Business Mailing Address
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Address Line | 819 N MILLER ST SUITE 1B
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City | WENATCHEE
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State | WA
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Zip | 98801-6604
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Country | US
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Telephone | 509-888-1924
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Fax | 509-888-2238
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Authorized Official
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Title or Position | OWNER
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Name | STACY R STUBBLEFIELD
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Credential | CNM/ARNP
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Telephone | 509-421-5077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number |
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State | WA
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