Mr James Timothy Stackhouse, CRNA is a
Nurse Anesthetist, Certified Registered based in Shiprock, New Mexico. Mr James Timothy Stackhouse is licensed to practice in Arizona (license number CRNA0631) and his current practice location is
Us Hwy 491 North, Shiprock, New Mexico. He can be reached at his office (for appointments etc.) via phone at
(505) 368-6401.
NPI number for Mr James Timothy Stackhouse is 1730177494 and his current mailing address is Po Box 160, Shiprock, New Mexico. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1730177494.
Provider's Profile
Full Name | Mr James Timothy Stackhouse |
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Gender | Male |
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Speciality | Nurse Anesthetist, Certified Registered |
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Location | Us Hwy 491 North, Shiprock, New Mexico |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1730177494
- Provider Enumeration Date: 10/07/2005
- Last Update Date: 01/25/2011
Medical Identifiers
Medical identifiers for Mr James Timothy Stackhouse such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1730177494 | NPI | - | NPPES |
697766 | Medicaid | AZ | |
79836534 | Medicaid | CO | |
R5071 | Medicaid | NM | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
367500000X | Nurse Anesthetist, Certified Registered | 03435481 (New York) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | CRNA0631 (Arizona) | Primary |
367500000X | Nurse Anesthetist, Certified Registered | R49230NM (Arizona) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | CRNA00781 (New Mexico) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr James Timothy Stackhouse is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr James Timothy Stackhouse, CRNA Po Box 160, Shiprock, NM 87420-0160 Ph: (505) 368-6401 | Mr James Timothy Stackhouse, CRNA Us Hwy 491 North, Shiprock, NM 87420 Ph: (505) 368-6401 |
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