| Doctor Name: | MRS. JESSICA TANDY STAHLE |
| NPI Number: | 1598051070 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 480 Cloverdale Rd North Salt Lake, UT - 840542323 |
| Business Phone Number: | 8018310630 |
| Business Fax Number: | 8017979412 |
| Mailing Address: | 480 Cloverdale Rd, NORTH SALT LAKE |
| State: | UT |
| Postal Code: | 840542323 |
| Phone Number: | 8018310630 |
| Fax Number: | 8017979412 |
| NPI Enumeration Date: | 06/23/2011 |
| NPI Last Update Date: | 06/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 175M00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Midwife, Lay |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A person qualified by experience and limited specialized training to provide obstetric and neo-natal care in the management of women having normal pregnancy, labor and childbirth. The lay midwife is licensed in some states. |