Healthcare Provider Details

I. General information

NPI: 1548959018
Provider Name (Legal Business Name): JESSICA MARIE STONEHOCKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S. TWINING ROAD, BLDG 760
MONTGOMERY AL
36112
US

IV. Provider business mailing address

300 S. TWINING ROAD, BLDG 760
MONTGOMERY AL
36112
US

V. Phone/Fax

Practice location:
  • Phone: 334-953-3368
  • Fax:
Mailing address:
  • Phone: 334-953-3368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number136965
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: