Individual
MS. KELLY JEANNETTE STAUTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2451 FILLINGIM ST, 3RD FLOOR, MOBILE, AL 36617-2238
(251) 471-7944
(251) 471-7451
Mailing address
PO BOX 40010, MOBILE, AL 36640-0010
(251) 471-7944
(251) 471-7451
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-071676
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511-01530
BLUE CROSS OF AL
AL
Enumeration date
06/24/2006
Last updated
01/09/2013
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