Provider Demographics
NPI:1053625541
Name:STAHL, KATHLEEN M (NP)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:M
Last Name:STAHL
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:630 E 1400 N STE 135
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-2549
Mailing Address - Country:US
Mailing Address - Phone:435-787-8146
Mailing Address - Fax:435-787-8149
Practice Address - Street 1:652 S MEDICAL CENTER DR STE 110
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7077
Practice Address - Country:US
Practice Address - Phone:435-787-8146
Practice Address - Fax:435-787-8149
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2021-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT374568-4408363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily