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NPI 1205077062

NPI 1205077062 : XENIA WILMA STONE : WINDHAM, NH

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General NPI Number Information
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    NPI Number           |    1205077062
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    Entity Type          |    Individual 
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    Provider Name        |    XENIA WILMA STONE
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/09/2009
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    Last Update Date     |    03/09/2009
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Provider Practice Location Address
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    Address Line         |    22 ORIOLE RD 
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    City                 |    WINDHAM
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    State                |    NH
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    Zip                  |    03087-1614
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    Country              |    US
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    Telephone            |    603-432-6192
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    22 ORIOLE RD 
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    City                 |    WINDHAM
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    State                |    NH
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    Zip                  |    03087-1614
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    Country              |    US
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    Telephone            |    603-432-6192
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    Fax                  |    
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    6317
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    License Number State |    NH
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