PHYLLIS C STACKHOUSE

STATE COLLEGE, PA
NPI1215056718
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: PA  SP-001330-D)
Additional Taxonomies163W00000X Registered Nurse
(Licence: PA  RN-204012-L)
Enumeration Date2007-03-28
Last Update Date2016-12-15
Business Address
PHYLLIS C STACKHOUSE CRNP
476 ROLLING RIDGE DR SUITE 101
STATE COLLEGE, PA 16801-7639
Phone number: 814-689-4980
Mailing Address
PHYLLIS C STACKHOUSE CRNP
476 ROLLING RIDGE DR SUITE 101
STATE COLLEGE, PA 16801-7639
Phone number: 814-689-4980