Individual
STACY LOLITA MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7494
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN-291589
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3049623
—
OH
Enumeration date
05/03/2010
Last updated
09/14/2010
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