1891776886 NPI number — MRS. JANET M STAHL MS SLP CCC

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:
Provider Last Name (Legal Name)	:	STAHL
Provider First Name	:	JANET
Provider Middle Name	:	M
Provider Name Prefix Text	:	MRS.
Provider Name Suffix Text	:
Provider Credential Text	:	MS SLP CCC
Provider Gender Code	:	F

Provider Other Organization Name	:
Provider Other Organization Name Type Code	:
Provider Other Last Name	:	LYONS
Provider Other First Name	:	JANET
Provider Other Middle Name	:	M
Provider Other Name Prefix Text	:
Provider Other Name Suffix Text	:
Provider Other Credential Text	:	SLP
Provider Other Last Name Type Code	:	1

NPI Number	:	1891776886
Entity Type Code	:	Individual
Replacement NPI	:
Last Update Date	:	07/09/2007
NPI Deactivation Reason Code	:
NPI Deactivation Date	:
NPI Reactivation Date	:

Provider First Line Business Mailing Address	:	818 NEWTOWN RD
Provider Second Line Business Mailing Address	:
Provider Business Mailing Address City Name	:	VIRGINIA BEACH
Provider Business Mailing Address State Name	:	VA
Provider Business Mailing Address Postal Code	:	234621116
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	7574738016
Provider Business Mailing Address Fax Number	:	7574733580

Provider First Line Business Practice Location Address	:	818 NEWTOWN RD
Provider Second Line Business Practice Location Address	:
Provider Business Practice Location Address City Name	:	VIRGINIA BEACH
Provider Business Practice Location Address State Name	:	VA
Provider Business Practice Location Address Postal Code	:	234621116
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	7574738016
Provider Business Practice Location Address Fax Number	:	7574733580
Provider Enumeration Date	:	11/08/2005

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

• Taxonomy code: 235Z00000X , with the licence number:  2202002906 , registered in the state of VA .

• Identifier: 35062 . This is a "OPTIMA" identifier . This identifiers is of the category "".
• Identifier: 4980093 , issued by the state of ( VA ) . This identifiers is of the category "".
• Identifier: 007328 . This is a "ANTHEM BLUE CROSS GROUP" identifier . This identifiers is of the category "".
• Identifier: 64 00313 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "".
• Identifier: H96651 , issued by the state of ( VA ) . This identifiers is of the category "".
• Identifier: 5275769 . This is a "AETNA GROUP" identifier . This identifiers is of the category "".
• Identifier: 11230802 . This is a "CAQH" identifier . This identifiers is of the category "".
• Identifier: 350034 . This is a "OPTIMA GROUP" identifier . This identifiers is of the category "".
• Identifier: 9116460 . This is a "MEDICAID DME" identifier , issued by the state of ( VA ) . This identifiers is of the category "".
• Identifier: 7039322 . This is a "AETNA" identifier . This identifiers is of the category "".
• Identifier: 219567 . This is a "ANTHEM BLUE CROSS" identifier . This identifiers is of the category "".
• Identifier: 4980093 . This is a "VIRGINIA PREMIER HEALTH P" identifier . This identifiers is of the category "".