Provider Demographics
NPI:1013676311
Name:STONEMAN, SANDY (MS)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:STONEMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-4412
Mailing Address - Country:US
Mailing Address - Phone:276-223-6040
Mailing Address - Fax:
Practice Address - Street 1:2110 N 4TH ST
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-4412
Practice Address - Country:US
Practice Address - Phone:276-223-6040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator