Provider Demographics
NPI:1558005793
Name:STOLTZFUS, ANNA GRACE
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:GRACE
Last Name:STOLTZFUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 BEESON RD
Mailing Address - Street 2:
Mailing Address - City:LASHMEET
Mailing Address - State:WV
Mailing Address - Zip Code:24733-9718
Mailing Address - Country:US
Mailing Address - Phone:276-227-1869
Mailing Address - Fax:
Practice Address - Street 1:2401 BEESON RD
Practice Address - Street 2:
Practice Address - City:LASHMEET
Practice Address - State:WV
Practice Address - Zip Code:24733-9718
Practice Address - Country:US
Practice Address - Phone:276-227-1869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant