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Individual

MICHAEL STEPHAN STOVALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
315 OAK ST, LIVINGSTON, TN 38570-1728
(931) 823-5611
(615) 620-2320
Mailing address
PO BOX 440246, NASHVILLE, TN 37244-0246
(615) 620-2320
(615) 620-2323

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN131795
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN11058
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4179675
BLUE CROSS/BLUE SHIELD OF TN
TN
Enumeration date
05/20/2006
Last updated
05/27/2010
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