Provider Demographics
NPI:1700238359
Name:JONES-STADLER, KATHRYN (APRN-CNM)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:JONES-STADLER
Suffix:
Gender:F
Credentials:APRN-CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16708 FISCHER RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-5536
Mailing Address - Country:US
Mailing Address - Phone:216-402-0211
Mailing Address - Fax:
Practice Address - Street 1:16708 FISCHER RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-5536
Practice Address - Country:US
Practice Address - Phone:216-402-0211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-07
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH019303367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife