Provider Demographics
NPI:1285358168
Name:STOPKE, JAMIE NICOL
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:NICOL
Last Name:STOPKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 COTILLION CT
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8131
Mailing Address - Country:US
Mailing Address - Phone:636-284-0882
Mailing Address - Fax:
Practice Address - Street 1:2000 INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-4725
Practice Address - Country:US
Practice Address - Phone:636-445-5190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant