Individual
SUSAN D STOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1200 S ROGERS ST, BLOOMINGTON, IN 47403-4792
(812) 339-6434
(812) 331-0196
Mailing address
1200 S ROGERS ST, BLOOMINGTON, IN 47403-4792
(812) 339-6434
(812) 331-0196
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000073A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300012943
—
IN
Enumeration date
06/16/2005
Last updated
03/09/2021
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