Individual
MRS. STACY RUTH ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
4176 STATE ROUTE 306, WILLOUGHBY, OH 44094-9203
(440) 918-4630
(440) 918-4620
Mailing address
7590 AUBURN ROAD, SUITE 014, ATTN: MED STAFF, CONCORD TWP, OH 44077-9176
(440) 354-1899
(440) 354-1845
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
COA.06089-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2203627
—
OH
01
—
H020110
MEDICARE
OH
Enumeration date
11/30/2005
Last updated
03/03/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us