Beth Ann Shay-Stidom
Physician Assistant, Medical in Fort Campbell, KY. Individual provider (NPI-1).
NPI number1437460698
StatusActive
Last updated in NPPESJun 23, 2010
Details
- NPI
- 1437460698
- Entity type
- Individual (NPI-1)
- Name
- Beth Ann Shay-Stidom
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 23, 2010
- Last updated
- Jun 23, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | – | – | Yes |
Practice location
650 Joel DrFort Campbell, KY 42223-5318
Phone 270-798-8372
Mailing address
650 Joel DrFort Campbell, KY 42223-5318
Phone 270-798-8372
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All 18 Medical Physician Assistant providers in Fort Campbell · All 1,373 providers in Fort Campbell
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