Basic Information
Provider Information
NPI: 1013004837
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STETLER
FirstName: DEBORAH
MiddleName: JO
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 515 28 3/4 RD
Address2: BLDG A
City: GRAND JUNCTION
State: CO
PostalCode: 815015016
CountryCode: US
TelephoneNumber: 9706837107
FaxNumber: 9706837167
Practice Location
Address1: 515 28 3/4 RD
Address2:  
City: GRAND JUNCTION
State: CO
PostalCode: 815015016
CountryCode: US
TelephoneNumber: 9702416023
FaxNumber: 9702428330
Other Information
ProviderEnumerationDate: 10/05/2006
LastUpdateDate: 07/24/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X29866COY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


Home