Individual
MICHAEL L STAHLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1303 NE CUSHING DR, BEND, OR 97701-3730
(541) 330-8226
(541) 318-0373
Mailing address
1303 NE CUSHING DR, SUITE 100, BEND, OR 97701-3887
(541) 388-2333
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200540385RN
OR
363LA2100X
Acute Care Nurse Practitioner
200550022NP
OR
363LF0000X
Family Nurse Practitioner
Primary
200550023NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079934
—
OR
01
—
P00414327
RAILROAD MEDICARE
OR
Enumeration date
04/26/2006
Last updated
09/26/2018
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