Individual
STACEY JUNG STITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
707 MOON ROAD, PLAINFIELD, IN 46168
(317) 839-7737
Mailing address
PO BOX 544, MONTICELLO, IN 47960-0544
(219) 863-7040
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28192473A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71012947A
APRN PRESCRIPTIVE AUTHORITY
IN
Enumeration date
09/09/2022
Last updated
09/09/2022
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