Provider Demographics
NPI:1013916303
Name:STOESSEL, NICOLE JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:JEAN
Last Name:STOESSEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2600 GLASGOW AVE STE 124
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4777
Mailing Address - Country:US
Mailing Address - Phone:302-256-8622
Mailing Address - Fax:302-340-7444
Practice Address - Street 1:2207 CONCORD PIKE # 207
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-2908
Practice Address - Country:US
Practice Address - Phone:302-256-8622
Practice Address - Fax:302-340-7444
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000508111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE51-0256713OtherBLUE CROSS
CT3713761OtherAETNA
CT3713761OtherAETNA
DEG0189IU03Medicare UPIN