Individual
SUSAN JOAN STAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R 1012097
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020742000
—
MN
05
—
43865300
—
WI
Enumeration date
07/17/2006
Last updated
06/20/2011
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