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General NPI Number Information
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NPI Number | 1003093790
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Entity Type | Individual
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Provider Name | JESSICA EILEEN STOLZ RN,MSN,C-FNP
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Gender | Female
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Dates
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Enumeration Date | 01/25/2008
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Last Update Date | 11/24/2021
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Provider Practice Location Address
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Address Line | 400 MATTHEW ST STE 302
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City | MARIETTA
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State | OH
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Zip | 45750
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Country | US
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Telephone | 740-568-5207
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Fax | 740-568-5297
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Provider Business Mailing Address
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Address Line | 400 MATTHEW ST STE 302
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City | MARIETTA
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State | OH
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Zip | 45750-1656
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Country | US
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Telephone | 740-568-5207
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Fax | 740-568-5297
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 57200
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | WV57200
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 09837
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License Number State | OH
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