Individual
JENNA ROSE STODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4100 PARK FOREST DR STE 200, TRAVERSE CITY, MI 49684-7306
(231) 600-7466
(877) 370-4631
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4704330253
MI
363LF0000X
Family Nurse Practitioner
Primary
4704330253
MI
Other
Enumeration date
02/13/2024
Last updated
07/16/2026
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