Individual provider · Type 1 NPI

Beth Ann Shay-Stidom

Medical Physician Assistant · Fort Campbell, KY

NPI number 1437460698 Active

Practice location

650 Joel Dr
Fort Campbell, KY 42223-5318

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1437460698

Beth Ann Shay-Stidom's National Provider Identifier is 1437460698, issued on Jun 23, 2010. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Fort Campbell, KY. The record was last updated on Jun 23, 2010.