Individual
MRS. SHAWNA L STALLCOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
51600 HUNTINGTON RD, LAPINE, OR 97739
(541) 536-3435
(541) 536-8047
Mailing address
PO BOX 3300, LAPINE, OR 97739
(541) 536-3435
(541) 536-8047
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200150091NP
OR
Other
Enumeration date
05/17/2006
Last updated
10/25/2011
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