Individual
STACY JEAN KAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11141 PARKVIEW PLAZA DR STE 310, FORT WAYNE, IN 46845-1714
(260) 266-8840
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28247504A
IN
363L00000X
Nurse Practitioner
Primary
71012027A
IN
Other
Enumeration date
11/20/2021
Last updated
10/15/2022
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