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1679511141
GWEN VIRGINIA STACKHOUSE
FLORENCE, AL
NPI
1679511141
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: AL 1-038721)
Enumeration Date
2006-06-04
Last Update Date
2007-07-08
Business Address
-- GWEN VIRGINIA STACKHOUSE CRNA
205 MARENGO ST
FLORENCE, AL 35630-6033
Phone number: 256-768-9191
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Mailing Address
-- GWEN VIRGINIA STACKHOUSE CRNA
PO BOX 10005
FLORENCE, AL 35631-2005
Phone number: 256-768-9191
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