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General NPI Number Information
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NPI Number | 1194943043
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Entity Type | Individual
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Provider Name | ADRIENNE WEAVER STAHL CRC, QRP
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 714 VENTURE DR # 216
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City | MORGANTOWN
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State | WV
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Zip | 26508-7306
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Country | US
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Telephone | 304-904-7267
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Fax | 304-292-1890
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Provider Business Mailing Address
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Address Line | 714 VENTURE DR # 216
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City | MORGANTOWN
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State | WV
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Zip | 26508-7306
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Country | US
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Telephone | 304-904-7267
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Fax | 304-292-1890
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | QRP00000264
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License Number State | WV
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