Individual
MARK DAVID STAATS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
3999 RICHMOND RD, BEACHWOOD, OH 44122-6046
(216) 593-5800
(216) 593-5800
Mailing address
3186 WEXFORD BLVD, STOW, OH 44224-2860
(330) 329-0093
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.021564
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F07170916
AMERICAN ASSOCIATION OF NURSE PRACTITIONERS
—
Enumeration date
08/21/2017
Last updated
08/21/2017
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