MEDICARE: DR. HANNAH STULL AUD

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	237600000X	Audiologist-Hearing Aid Fitter	DA13827	AZ

General Provider Information

NPI Number	:	1770210601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HANNAH STULL AUD

Provider Business Mailing Address
First Line	:	13985 W GRAND AVE STE 101
Second Line	:
City	:	SURPRISE
State	:	AZ
Zip	:	85374-3626
Country	:	US
Telephone Number	:	623-594-5095
Fax Number	:

Provider Business Practice Location Address
First Line	:	13985 W GRAND AVE STE 101
Second Line	:
City	:	SURPRISE
State	:	AZ
Zip	:	85374-3626
Country	:	US
Telephone Number	:	623-594-5095
Fax Number	:

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

Provider Enumeration Date	:	08/02/2022
Last Update Date	:	08/02/2022

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