Individual
STACEY SPEARS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
852 E 144TH ST, CLEVELAND, OH 44110-3418
(216) 308-8124
Mailing address
852 E 144TH ST, CLEVELAND, OH 44110-3418
(216) 308-8124
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
402233561219
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10290809028
—
OH
Enumeration date
02/18/2020
Last updated
02/18/2020
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