Provider Demographics
NPI:1104881598
Name:STAUSS, JENNIFER J (WHNP-BC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:J
Last Name:STAUSS
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNNE
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:915 TATE BLVD SE
Mailing Address - Street 2:STE 170
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-4042
Mailing Address - Country:US
Mailing Address - Phone:828-345-0800
Mailing Address - Fax:828-345-0350
Practice Address - Street 1:915 TATE BLVD SE
Practice Address - Street 2:STE 170
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4042
Practice Address - Country:US
Practice Address - Phone:828-345-0800
Practice Address - Fax:828-345-0350
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96155363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health