Stall, Theresa B.
Stall, Theresa B. is an individual health care provider with primary practice located at 7050 Smoke Ranch Rd Ste 130, Las Vegas NV 89128-8609. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Stall, Theresa B. can be contacted via phone (702) 233-9911.Contact Information
Primary practice address
7050 Smoke Ranch Rd Ste 130
Las Vegas NV 89128-8609
Phone: (702) 233-9911
Fax: (702) 243-5568
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | AP30007643 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | 1007373 | District of Columbia |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | APN001380 | Nevada |
Profile Details
| NPI number | 1669500120 |
|---|---|
| LBN Legal business name | Stall, Theresa B. |
| Credentials | ARNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 28th, 2007 |
| Last updated | May 31st, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669500120 | NPPES |
| Washington | Other | 0219957 | L&I |
| Washington | MEDICAID | 9652496 | L&I |
| Washington | Other | 03851U | L&I |
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