Provider Demographics
NPI:1104602143
Name:STOLL, CLARA J (CPM-TN)
Entity type:Individual
Prefix:MRS
First Name:CLARA
Middle Name:J
Last Name:STOLL
Suffix:
Gender:F
Credentials:CPM-TN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1379 MCCORD HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:HOHENWALD
Mailing Address - State:TN
Mailing Address - Zip Code:38462-5314
Mailing Address - Country:US
Mailing Address - Phone:731-468-4226
Mailing Address - Fax:
Practice Address - Street 1:1379 MCCORD HOLLOW RD
Practice Address - Street 2:
Practice Address - City:HOHENWALD
Practice Address - State:TN
Practice Address - Zip Code:38462-5314
Practice Address - Country:US
Practice Address - Phone:731-468-4226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife