MEDICARE: ALICIA Y STASHER RN

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	163W00000X	Registered Nurse	517177	OH

General Provider Information

NPI Number	:	1689904088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA Y STASHER RN

Provider Business Mailing Address
First Line	:	55 SAN RAFAEL AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43607-2413
Country	:	US
Telephone Number	:	419-531-2077
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 SAN RAFAEL
Second Line	:
City	:	TOLEDO
State	:	OHIO
Zip	:	43607
Country	:	UM
Telephone Number	:	419-531-2077
Fax Number	:

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

Provider Enumeration Date	:	01/06/2010
Last Update Date	:	05/26/2026

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