Individual
MISS JOLIE ANN STADELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5222 MOYE ROAD, TRENT WOODS, NC 28562-7458
(216) 513-0791
(252) 633-8004
Mailing address
5222 MOYE ROAD, TRENT WOODS, NC 28562-7458
(216) 513-0791
(252) 633-8004
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-02241
NC
363A00000X
Physician Assistant
1056
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-02241
NC
NC
05
—
1962698753
—
NV
01
—
NV7279
BC/BS
NV
Enumeration date
09/14/2007
Last updated
06/25/2012
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