Provider Demographics
NPI:1487623005
Name:STUMP, JANICE WHITING (NP)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:WHITING
Last Name:STUMP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 BRENTWOOD CENTER LN N
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-1710
Mailing Address - Country:US
Mailing Address - Phone:252-237-1610
Mailing Address - Fax:252-237-1630
Practice Address - Street 1:114 BRENTWOOD CENTER LN N
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-1710
Practice Address - Country:US
Practice Address - Phone:252-237-1610
Practice Address - Fax:252-237-1630
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201164363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7000916Medicaid
NC018JFOtherBCBS
NC2599470AMedicare PIN