Individual
AMANDA LYNN STAUDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
3632 RIDGEWOOD RD, FAIRLAWN, OH 44333-3124
(330) 666-6266
(330) 666-6265
Mailing address
3632 RIDGEWOOD RD, FAIRLAWN, OH 44333-3124
(330) 666-6266
(330) 666-6265
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
NP-14025
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0075665
—
OH
Enumeration date
11/05/2012
Last updated
11/08/2016
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