Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 035179-23 | NH |
NPI | 1033284120 |
---|---|
Provider Name | Julia M Stauble |
First Address | Nashua, NH 03063-1818 |
Second Address | Nashua, NH 03063-1818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 21/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P80470 | (02) | NH |