Provider Demographics
NPI:1720708779
Name:STILTNER, KERRY JANE (HOME CARE)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:JANE
Last Name:STILTNER
Suffix:
Gender:F
Credentials:HOME CARE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 VINE ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-8781
Mailing Address - Country:US
Mailing Address - Phone:740-285-5611
Mailing Address - Fax:
Practice Address - Street 1:59 VINE ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-8781
Practice Address - Country:US
Practice Address - Phone:740-285-5611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty