Provider Demographics
NPI:1225355837
Name:STAHL, KARELYN (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:KARELYN
Middle Name:
Last Name:STAHL
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 N. OCEAN BLVD.
Mailing Address - Street 2:APT 101 CAMBRIDGE BLDG
Mailing Address - City:OCEAN RIDGE
Mailing Address - State:FL
Mailing Address - Zip Code:33435
Mailing Address - Country:US
Mailing Address - Phone:561-358-6643
Mailing Address - Fax:
Practice Address - Street 1:5505 N. OCEAN BLVD.
Practice Address - Street 2:APT 101 CAMBRIDGE BLDG
Practice Address - City:OCEAN RIDGE
Practice Address - State:FL
Practice Address - Zip Code:33435
Practice Address - Country:US
Practice Address - Phone:561-358-6643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1949442163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRNLICENSE#1949442OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH