Individual
TAMMIE L KELLEY STAHR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1001 S RAISINVILLE RD, MONROE, MI 48161-9754
(734) 243-7340
Mailing address
2700 LACKAWANNA AVE LOT 12, BLOOMSBURG, PA 17815-3201
(570) 204-2809
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN616419
PA
163WC1500X
Community Health Registered Nurse
4704392600
MI
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN616419
PA
Other
Enumeration date
08/02/2022
Last updated
09/18/2023
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