Provider Demographics
NPI:1003093790
Name:STOLZ, JESSICA EILEEN (RN,MSN,C-FNP)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:EILEEN
Last Name:STOLZ
Suffix:
Gender:F
Credentials:RN,MSN,C-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 MATTHEW ST STE 302
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-1656
Mailing Address - Country:US
Mailing Address - Phone:740-568-5207
Mailing Address - Fax:740-568-5297
Practice Address - Street 1:400 MATTHEW ST STE 302
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750
Practice Address - Country:US
Practice Address - Phone:740-568-5207
Practice Address - Fax:740-568-5297
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV57200363LF0000X
WVWV57200363LF0000X
OH09837363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily