Individual
JESSICA ANNE STANELUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 EDDY STREET, PROVIDENCE, RI 02905
(401) 533-9100
Mailing address
1000 EDDY STREET, PROVIDENCE, RI 02905
(401) 533-9100
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0614
NHP RI
RI
05
—
ES01788
—
RI
01
—
SB870
BC RI
RI
Enumeration date
06/17/2010
Last updated
03/06/2020
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