Provider Demographics
NPI:1629471818
Name:STANKUS, JOSEPH (APRN)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:STANKUS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18743 NW 234TH ST
Mailing Address - Street 2:
Mailing Address - City:HIGH SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32643-0465
Mailing Address - Country:US
Mailing Address - Phone:386-454-0721
Mailing Address - Fax:386-454-0722
Practice Address - Street 1:18743 NW 234TH ST
Practice Address - Street 2:
Practice Address - City:HIGH SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32643-0465
Practice Address - Country:US
Practice Address - Phone:386-454-0721
Practice Address - Fax:386-454-0722
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-01
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9263899363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care