| Doctor Name: | JERRY A STALLINGS |
| NPI Number: | 1669623609 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARNP, FNP |
| License Number: | AP05589 |
| Business Practice Address: | 155a Ninth Street Jena, LA - 713420000 |
| Business Phone Number: | 3189924275 |
| Business Fax Number: | 3189922825 |
| Mailing Address: | 187 Ninth Street, Po Box 2780 JENA |
| State: | LA |
| Postal Code: | 713422780 |
| Phone Number: | 3189929200 |
| Fax Number: | 3189929245 |
| NPI Enumeration Date: | 10/08/2008 |
| NPI Last Update Date: | 10/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP05589 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |