MEDICARE: ALYSON MCKAY STAHLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	SP012645	PA
2	363LF0000X	Family Nurse Practitioner	26NJ00595400	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124365333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSON MCKAY STAHLER

Provider Business Mailing Address
First Line	:	1 FEDERAL ST # 200
Second Line	:
City	:	CAMDEN
State	:	NJ
Zip	:	08103-1088
Country	:	US
Telephone Number	:	856-356-4924
Fax Number	:

Provider Business Practice Location Address
First Line	:	196 GROVE AVE STE C
Second Line	:
City	:	WEST DEPTFORD
State	:	NJ
Zip	:	08086-2139
Country	:	US
Telephone Number	:	856-848-7577
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2013
Last Update Date	:	12/03/2020

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Directions to “ ALYSON MCKAY STAHLER ” Practice Location

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