1760075378 NPI number — JEAN MARIE STAHLECKER MS, ATC, CSCS

Table of content: JEAN MARIE STAHLECKER MS, ATC, CSCS (NPI 1760075378)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760075378 NPI number — JEAN MARIE STAHLECKER MS, ATC, CSCS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STAHLECKER
Provider First Name:
JEAN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, ATC, CSCS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TROIANO
Provider Other First Name:
JEAN
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, ATC, CSCS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1760075378
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/15/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
US ARMY MEDICAL ACTIVITY-BAVARIA UNIT 28038
Provider Second Line Business Mailing Address:
ATTN: MCEU-BAV-CRE
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
US ARMY MEDICAL ACTIVITY-BAVARIA UNIT 28038
Provider Second Line Business Practice Location Address:
ATTN: MCEU-BAV-CRE
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09112-0911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
172-343-9205
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/15/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2255A2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)