Active NPI
Jennifer Stull, RN
- Registered Nurse
- Princeton, WV
National Provider Identifier
1831875707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 64665
- Practice address
- 150 Courthouse Rd Suite 301a
Princeton, WV 24740 - Phone
- (304) 325-3378
- NPI assigned
- Jun 26, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 64665 | WV | Primary |
Addresses
Primary practice location
150 Courthouse Rd Suite 301a
Princeton, WV 24740
Mailing address
522 Quailwood Dr
Princeton, WV 24740
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64665 | WV | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centerwell Certified Healthcare Corp | Past | Accepting new patients | |
| Centerwell Certified Healthcare Corp | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1831875707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 QUAILWOOD DR",
"city": "PRINCETON",
"state": "WV",
"postal_code": "24740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 COURTHOUSE RD SUITE 301A",
"city": "PRINCETON",
"state": "WV",
"postal_code": "24740",
"telephone_number": "304-325-3378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STULL",
"first_name": "JENNIFER",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-26",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WV",
"license": "64665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Princeton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.