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General NPI Number Information
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NPI Number | 1609744895
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Entity Type | Individual
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Provider Name | JACLYN E STULL
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Gender | Female
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 55 ARCH ST STE 2A
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City | AKRON
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State | OH
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Zip | 44304-1424
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Country | US
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Telephone | 330-375-9617
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Fax |
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Provider Business Mailing Address
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Address Line | 10265 BOSTON AVE NW
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City | NORTH CANTON
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State | OH
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Zip | 44720-4425
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Country | US
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Telephone |
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN.CNP.0040538
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.418203
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License Number State | OH
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