Individual
CRISTA STULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
371 MAPLE DR, CRESTLINE, OH 44827-1336
(419) 564-5890
(419) 564-5890
Mailing address
371 MAPLE DR, CRESTLINE, OH 44827-1336
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.128643-IV
OH
Other
Enumeration date
04/09/2009
Last updated
04/09/2009
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