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Individual
THERESA B. STALL
Active
Individual
THERESA B. STALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN001380
NV
363LA2100X
Acute Care Nurse Practitioner
1007373
DC
363LA2100X
Acute Care Nurse Practitioner
AP30007643
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0219957
L&I
WA
01
—
03851U
REGENCE BLUE SHIELD
WA
05
—
9652496
—
WA
Enumeration date
02/28/2007
Last updated
05/31/2012
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