Individual
KYLE STUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-2025
(570) 271-6621
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN618364
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2016
Last updated
11/14/2016
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