Provider Demographics
NPI:1194869925
Name:STAMBAUGH-HELLER, BECKY (CST, SFA)
Entity type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:
Last Name:STAMBAUGH-HELLER
Suffix:
Gender:F
Credentials:CST, SFA
Other - Prefix:MS
Other - First Name:BECKY
Other - Middle Name:
Other - Last Name:STAMBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CST, SFA
Mailing Address - Street 1:1980 W HOSPITAL DR
Mailing Address - Street 2:STE. 111
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7802
Mailing Address - Country:US
Mailing Address - Phone:520-575-1272
Mailing Address - Fax:520-575-1789
Practice Address - Street 1:1980 W HOSPITAL DR
Practice Address - Street 2:STE. 111
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7802
Practice Address - Country:US
Practice Address - Phone:520-575-1272
Practice Address - Fax:520-575-1789
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ071397246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist