Provider Demographics
NPI:1396720975
Name:STOCKLINSKI, EILEEN M (NP)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:M
Last Name:STOCKLINSKI
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:PO BOX 409
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-0011
Mailing Address - Country:US
Mailing Address - Phone:706-769-6469
Mailing Address - Fax:706-769-4402
Practice Address - Street 1:1550 MARS HILL RD
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-4836
Practice Address - Country:US
Practice Address - Phone:706-769-4852
Practice Address - Fax:706-769-8372
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAR047052363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner