Jennifer Amber Acitelli-Stofan, RN
Individual provider Active NPI Registered Nurse · Painesville, OH
NPI 1780103309 · NPPES record last updated Sep 14, 2017
Key facts
- NPI
- 1780103309
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN390488 (OH)
- Practice address
- 462 Chardon St
Painesville, OH 44077-3019 - Phone
- (440) 953-9999
- NPI assigned
- Sep 14, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN390488 | OH | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse |
163W00000X | RN390488 | OH | Yes |
Addresses
Primary practice location
462 Chardon St
Painesville, OH 44077-3019
Mailing address
38882 Mentor Ave
Willoughby, OH 44094-7875
Phone (440) 953-9999
Other providers in Painesville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.