Basic Information
| Provider Information | |||||||||
| NPI: | 1811006273 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STAHLMAN | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | JAY | ||||||||
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| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | STAHLMAN | ||||||||
| OtherFirstName: | JACK | ||||||||
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| OtherCredential: | NP | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 31 COLLEGE PL STE B100 | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288012400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282545008 | ||||||||
| FaxNumber: | 8282545808 | ||||||||
| Practice Location | |||||||||
| Address1: | 31 COLLEGE PL STE B100 | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288012400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282545008 | ||||||||
| FaxNumber: | 8282545808 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 10/20/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 950004 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 136JH | 01 | NC | NVML BCBSNC GRP # 015HF | OTHER | 6005015 | 05 | NC | MEDICAID |