Provider Demographics
NPI:1578996013
Name:STOCKTON, JANICE (CNS)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:STOCKTON
Suffix:
Gender:F
Credentials:CNS
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 636541
Mailing Address - Street 2:3 SOUTH
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6541
Mailing Address - Country:US
Mailing Address - Phone:513-585-2791
Mailing Address - Fax:513-421-2601
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:STE 204
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-585-2791
Practice Address - Fax:513-421-2601
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA03254NS364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health