Individual
DR. JENNA ELISE STODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2848 NILES RD, SAINT JOSEPH, MI 49085-3352
(269) 428-3300
(269) 428-5005
Mailing address
2848 NILES RD, SAINT JOSEPH, MI 49085-3352
(269) 428-3300
(269) 428-5005
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2688
NC
152W00000X
Optometrist
4901005923
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2688
NORTH CAROLINA OPTOMETRY LICENSE
NC
01
—
4901005923
LICENSING DIVISION BUREAU OF PROFESSIONAL LICENSING OPTOMETRY LICENSE
MI
Enumeration date
07/26/2018
Last updated
05/06/2026
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