Provider Demographics
NPI:1891356176
Name:STAHLHEBER, KRISTIN MICHELLE (DVM)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:MICHELLE
Last Name:STAHLHEBER
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6718 GOSHEN RD
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-3025
Mailing Address - Country:US
Mailing Address - Phone:618-207-4000
Mailing Address - Fax:
Practice Address - Street 1:6718 GOSHEN RD
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-3025
Practice Address - Country:US
Practice Address - Phone:618-207-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL090.009630174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist