Jill Nicole Stahl

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

611397 Issued in PA

Practice address

677 Kidder St
Wilkes Barre, PA 18702-6908

Phone

(570) 825-2046

NPI assigned

Mar 6, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jill Nicole Gordon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1043778236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 ELECTRIC ST",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111931",
            "telephone_number": "570-294-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 KIDDER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187026908",
            "telephone_number": "570-825-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHL",
        "first_name": "JILL",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "611397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "GORDON",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Beth Bridget Spellman, OTR/L
• Catherine Spencer, RN, BSN
• Cindy Lou Spock
• St. Luke'S Villa
• Jennifer Stahl
• Stallington Dialysis LLC
• Anthony Stambone III, PHARMD
• Rebecca Ann Stankoski, PHD, CRNP
• Dominika Stanton, PA-C
• Jason Michael Stanton, DO

• Nurse Practitioner in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.