Individual
STACEY MARIE JANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
40 W ERIE ST, SUITE 203, PAINESVILLE, OH 44077-3274
(440) 350-0832
(440) 354-7420
Mailing address
700 N COLUMBUS ST, CRESTLINE, OH 44827-1455
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
COA.14005-NA
OH
Other
Enumeration date
10/16/2012
Last updated
02/29/2024
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