Provider Demographics
NPI:1225301393
Name:STOLL, AUBREY S (PA)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:S
Last Name:STOLL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:S
Other - Last Name:HANNUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:DEPT. OF ORTHOPAEDIC SURGERY
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:804-828-7051
Practice Address - Fax:804-828-7199
Is Sole Proprietor?:No
Enumeration Date:2012-02-20
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110003774363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant