Provider Demographics
NPI:1811006273
Name:STAHLMAN, JOHN JAY (NP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:JAY
Last Name:STAHLMAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:JACK
Other - Middle Name:
Other - Last Name:STAHLMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:31 COLLEGE PL STE B100
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2400
Mailing Address - Country:US
Mailing Address - Phone:828-254-5008
Mailing Address - Fax:828-254-5808
Practice Address - Street 1:31 COLLEGE PL STE B100
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2400
Practice Address - Country:US
Practice Address - Phone:828-254-5008
Practice Address - Fax:828-254-5808
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC950004363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC136JHOtherNVML BCBSNC GRP # 015HF
NC6005015Medicaid
NC6005015Medicaid
NC2598127FMedicare ID - Type UnspecifiedDR GRP # 2335660