MEDICARE: LISA MORRIS STILTNER MS CCC/SLP

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
1	235Z00000X	Speech-Language Pathologist	SLP-0988	WV
2	235Z00000X	Speech-Language Pathologist	30002945	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730351107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA MORRIS STILTNER MS CCC/SLP

Provider Business Mailing Address
First Line	:	2002 WT WHITEHEAD DR
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-8409
Country	:	US
Telephone Number	:	304-890-7071
Fax Number	:

Provider Business Practice Location Address
First Line	:	2002 WT WHITEHEAD DR
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-8409
Country	:	US
Telephone Number	:	304-890-7071
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2008
Last Update Date	:	04/10/2025

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