Healthcare Provider Details

I. General information

NPI: 1275086217
Provider Name (Legal Business Name): KAITLIN ELIZABETH STOPA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAITLIN ELIZABETH HACKETT ARNP

II. Dates (important events)

Enumeration Date: 07/26/2016
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SE HOSPITAL AVE
STUART FL
34994-2346
US

IV. Provider business mailing address

200 SE HOSPITAL AVE
STUART FL
34994-2346
US

V. Phone/Fax

Practice location:
  • Phone: 954-805-9806
  • Fax:
Mailing address:
  • Phone: 772-287-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9329681
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: