Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacqulyn Stachowiak

Individual provider Family Nurse Practitioner · NPI 1073068896

Jacqulyn Stachowiak is a Nurse Practitioner in Olmsted Twp, Ohio. Qualified in 2016, 10 years ago. Practices with Southwest General Medical Group Inc, a 235-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
10
Licensed in
OH
In the registry since
2016

Practice location Address checks out

27076 Bagley Rd
Olmsted Twp, OH 44138
Phone: (440) 816-8380
Fax: (440) 816-8383
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN.CNP.019712 (OH)

Record details

NPI number1073068896
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 22, 2016
Last updated in NPPESJune 3, 2022
Certification dateMay 24, 2022
Mailing address27076 Bagley Road, Olmsted Twp, OH 44138

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Southwest General Medical Group Inc — 235 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Olmsted Twp