Provider Demographics
NPI:1144312018
Name:STELZNER, JOAN MARIE (ANP)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:MARIE
Last Name:STELZNER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:MARIE
Other - Last Name:BLAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:650 PETER JEFFERSON PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8844
Mailing Address - Country:US
Mailing Address - Phone:434-293-4072
Mailing Address - Fax:434-293-4265
Practice Address - Street 1:650 PETER JEFFERSON PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8844
Practice Address - Country:US
Practice Address - Phone:434-293-4072
Practice Address - Fax:434-293-4265
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024189488363LA2200X
NC235865363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1144312018Medicaid
FL306603700Medicaid
NCNC5008A746OtherMEDICARE PTAN
NCNC5008A746OtherMEDICARE PTAN
FLU3901YMedicare PIN