Provider Demographics
NPI:1255878260
Name:STOLARSKI, KATHERINE MARIE (CST/CSFA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARIE
Last Name:STOLARSKI
Suffix:
Gender:F
Credentials:CST/CSFA
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MARIE
Other - Last Name:FULNECKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CST
Mailing Address - Street 1:135 JORDANS JOURNEY
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-1444
Mailing Address - Country:US
Mailing Address - Phone:757-221-0460
Mailing Address - Fax:
Practice Address - Street 1:135 JORDANS JOURNEY
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-1444
Practice Address - Country:US
Practice Address - Phone:757-221-0460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant