| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JAN K STOTTLEMYER | 1922052539 | 2024-01-07 |
Jan K Stottlemyer is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1922052539. Registration indicates Jan K Stottlemyer is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant: Medical, ) (All Other Specialties & Provider Types, ) (Physician Assistant Medical, Physician Assistants & Advanced Practice Nursing Providers) (Physician Assistant, ) Access to Adult/Geriatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Jan K Stottlemyer PA |
| Practice Office Address | 101 CASA BUENA DR CORTE MADERA, CA US |
| Practice Office Telephone | 5616350956 |
| Mailing Address | 1509 DUTCH LN PENNGROVE, CA 949519717 US |
| Business Telephone | 5616350956 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 2440 S Federal Hwy Suite 400A | Stuart, FL 349944500 | 5616350956 |
| Code | Practice | License No State |
|---|---|---|
| 363AM0700X | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant: Medical All Other Specialties & Provider Types Physician Assistant Medical Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | PA3632
FL |
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | 58964
CA |