Provider Demographics
NPI:1912448036
Name:STOLTZ, CHRISTY (MEDICAL ASSISTANT)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:STOLTZ
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N PINAUD ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MARTINVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70582-4732
Mailing Address - Country:US
Mailing Address - Phone:337-519-2033
Mailing Address - Fax:
Practice Address - Street 1:120 N PINAUD ST
Practice Address - Street 2:
Practice Address - City:SAINT MARTINVILLE
Practice Address - State:LA
Practice Address - Zip Code:70582-4732
Practice Address - Country:US
Practice Address - Phone:337-519-2033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical