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General NPI Number Information
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NPI Number | 1073904520
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Entity Type | Individual
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Provider Name | JENNIFER STAUFFER FNP
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Gender | Female
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Dates
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Enumeration Date | 02/05/2015
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 16888 HARVARD AVE
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City | CLEVELAND
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State | OH
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Zip | 44128-2208
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Country | US
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Telephone | 216-810-7159
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Fax | 216-920-6286
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Provider Business Mailing Address
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Address Line | PO BOX 746071
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City | ATLANTA
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State | GA
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Zip | 30374-6071
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Country | US
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Telephone | 312-733-9730
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Fax | 733-866-8014
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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 | COA.16877-NP
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License Number State | OH
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