Individual
STACI DAWN MARTIN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2600 SIXTH STREET SW, OHIO HOSPITAL BASED PHYSICIAN CORP, CANTON, OH 44710
(330) 363-7462
(330) 363-7679
Mailing address
2600 SIXTH STREET SW, OHIO HOSPITAL BASED PHYSICIAN CORP, CANTON, OH 44710
(330) 363-7462
(330) 363-7679
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
COA08483NA
OH
Other
Enumeration date
05/10/2006
Last updated
07/08/2007
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