Provider Demographics
NPI:1467791244
Name:STILTNER, ADAM CRAIG (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:CRAIG
Last Name:STILTNER
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1440
Mailing Address - Street 2:1109 PLAZA DRIVE
Mailing Address - City:GRUNDY
Mailing Address - State:VA
Mailing Address - Zip Code:24614-1440
Mailing Address - Country:US
Mailing Address - Phone:276-935-2677
Mailing Address - Fax:276-935-5775
Practice Address - Street 1:1109 PLAZA DR
Practice Address - Street 2:
Practice Address - City:GRUNDY
Practice Address - State:VA
Practice Address - Zip Code:24614-6780
Practice Address - Country:US
Practice Address - Phone:276-935-2677
Practice Address - Fax:276-935-5775
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily