Cruikshank, Stacey Beth

Cruikshank, Stacey Beth is an individual health care provider with primary practice located at 380 Butterfly Gardens Dr , Columbus OH 43215-7508. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Cruikshank, Stacey Beth can be contacted via phone (614) 722-2000.

Contact Information

Primary practice address
380 Butterfly Gardens Dr Columbus OH 43215-7508
Phone: (614) 722-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN.CNP.026491 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X APRN.CNP.026491 Ohio

Profile Details

NPI number 1487289286
LBN Legal business name Cruikshank, Stacey Beth
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 12th, 2020
Last updated Mar 9th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487289286 NPPES
Ohio MEDICAID 0425843

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