Individual
MRS. JENNIFER KAY STAHLECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-0920
(602) 933-2492
Mailing address
3200 E CAMELBACK RD STE 250, PHOENIX, AZ 85018-2327
(602) 933-1814
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP3647
AZ
364SX0204X
Pediatric Oncology Clinical Nurse Specialist
AP3647
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP3647
LICENSE
AZ
Enumeration date
07/06/2011
Last updated
09/23/2020
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