Individual
MICHELE STACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7101 JAHNKE RD, RICHMOND, VA 23225-4017
(804) 221-4173
Mailing address
9018 BRUCEWOOD DR, NORTH CHESTERFIELD, VA 23235-5014
(804) 221-4173
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
0001294268
VA
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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