Provider Demographics
NPI:1730500943
Name:STOLZMAN, JOHN (LPN)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:STOLZMAN
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 SUMNER ST
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-6554
Mailing Address - Country:US
Mailing Address - Phone:715-845-6107
Mailing Address - Fax:
Practice Address - Street 1:911 SUMNER ST
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-6554
Practice Address - Country:US
Practice Address - Phone:715-845-6107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI304695-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse