Individual
MS. DEANNA L STOPPERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1000 N LEBANON ST, JAMESTOWN, IN 46147-9372
(765) 676-5754
(765) 676-9853
Mailing address
2605 N LEBANON ST, LEBANON, IN 46052-1476
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28149608A
IN
363LF0000X
Family Nurse Practitioner
Primary
71002615A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200908760
—
IN
Enumeration date
03/03/2008
Last updated
10/11/2023
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