Rose, Stacy Ruth

Rose, Stacy Ruth is an individual health care provider with primary practice located at 4176 State Route 306 , Willoughby OH 44094-9203. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Rose, Stacy Ruth can be contacted via phone (440) 918-4630.

Contact Information

Primary practice address
4176 State Route 306 Willoughby OH 44094-9203
Phone: (440) 918-4630
Fax: (440) 918-4620
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X COA.06089-NP Ohio

Profile Details

NPI number 1689658031
LBN Legal business name Rose, Stacy Ruth
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Mar 3rd, 2021 - about 3 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 1689658031 NPPES
Ohio MEDICAID 2203627
Ohio Other H020110

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