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NPI Code Detail

MEDICARE: JESSICA OLA STASINSKI

MEDICARE: JESSICA OLA STASINSKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistAPRN11029199FL
2367500000XCertified Registered Nurse Anesthetist041428791IL

General Provider Information

NPI Number : 1043999022
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA OLA STASINSKI
Provider Business Mailing Address
First Line : 3660 N LAKE SHORE DR APT 3611
Second Line :
City : CHICAGO
State : IL
Zip : 60613-5316
Country : US
Telephone Number : 224-245-4994
Fax Number :
Provider Business Practice Location Address
First Line : 5352 LINTON BLVD
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33484-6514
Country : US
Telephone Number : 561-495-3095
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2023
Last Update Date : 02/05/2026

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