MRS. STACY RUTH ROSE (NPI# 1689658031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689658031 |
| Entity Type | Individual |
| Full Name | MRS. STACY RUTH ROSE |
| Credential | CRNP |
| Practice Address |
4176 State Route 306 Willoughby OH 44094-9203 |
| Mailing Address |
Po Box 781389 Detroit MI 48278-1389 |
| Practice Telephone | 4409184630 |
| Practice Fax Number | 4409184620 |
| Mailing Telephone | (440) 918-4630 |
| Mailing Fax Number | 4409184632 |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2017-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
COA.06089-NP | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2203627 | 05 | |
| OH | MEDICARE | H020110 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114101839 | Stacy Erin Rose | Counselor | 100 West 29th St, Suite 319, South Sioux, NE 68776 | 2007-12-18 |
| 1619286382 | Stacy A Rose | Physician Assistant | 800 W Central Rd, Arlington Heights, IL 60005-2349 | 2010-09-29 |
| Street Address |
4176 STATE ROUTE 306 |
| City | WILLOUGHBY |
| State | OH |
| Zip Code | 44094-9203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700875465 | Christine M Slotta | Obstetrics & Gynecology | 4176 State Route 306, Willoughby, OH 44094-9203 | 2005-10-17 |
| 1366857138 | Neelima D Rao | Internal Medicine | 4176 State Route 306, Willoughby, OH 44094-9203 | 2014-06-30 |
| 1437411626 | Iram Ramzan | Internal Medicine | 4176 State Route 306, Willoughby, OH 44094-9203 | 2012-06-13 |
| 1841582095 | Leticia Maria Cox | Obstetrics & Gynecology | 4176 State Route 306, Willoughby, OH 44094-9203 | 2011-05-06 |
| 1497056642 | Amy Marie Livingston | Nurse Practitioner | 4176 State Route 306, Willoughby, OH 44094-9203 | 2010-11-04 |
| 1104054352 | Thomesha Marie Barton | Obstetrics & Gynecology | 4176 State Route 306, Willoughby, OH 44094-9203 | 2009-06-26 |
| 1881635670 | Mihaela Donca | Internal Medicine | 4176 State Route 306, Willoughby, OH 44094-9203 | 2006-06-10 |
| 1518920917 | Wendy J Clinger | Obstetrics & Gynecology | 4176 State Route 306, Willoughby, OH 44094-9203 | 2006-04-08 |
| 1043273352 | Janie M Zart | Obstetrics & Gynecology | 4176 State Route 306, Willoughby, OH 44094-9203 | 2006-04-08 |
| 1225090004 | Liese K Vito | Obstetrics & Gynecology | 4176 State Route 306, Willoughby, OH 44094-9203 | 2006-04-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518574367 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 36596 Euclid Ave, Willoughby, OH 44094 | 2020-09-25 |
| 1679111322 | Megan King | Nurse Practitioner | 4078 Erie Street, Unit B, Willoughby, OH 44094 | 2019-12-12 |
| 1124661525 | Mind and Body Infusion Therapies, LLC | Clinic/Center | 9264 Chillicothe Rd., Unit #2, Kirtland, OH 44094 | 2019-10-18 |
| 1679125637 | Christina Maria Chandler | Family Medicine | 39021 Signature Circle, Willoughby, OH 44094 | 2019-07-10 |
| 1467920595 | Rachel Curry | Specialist/Technologist | 53400 Euclid Ave., Apt. E-102, Willoughby, OH 44094 | 2018-11-07 |
| 1437649753 | Katie Lauren Greenaway | Registered Nurse | 5103 Robinhood Dr, Willoughby, OH 44094 | 2018-05-11 |
| 1003346131 | Heather Marie Hayes | Licensed Practical Nurse | 38882 Mentor Ave., Willoughby, OH 44094 | 2017-06-12 |
| 1609305028 | Ann Marie Mason | Counselor | 38882 Mentor Avenue, Willoughby, OH 44094 | 2017-06-08 |
| 1285173005 | Mattie Diann Towns-scott | Social Worker | 34950 Chardon Road, Bldg 2, Suite 210, Willoughby Hills, OH 44094 | 2017-02-13 |
| 1447797329 | Therese Benz | General Acute Care Hospital | 96000 Euclid Ave., Willoughby, OH 44094 | 2017-01-30 |
| Find all providers in zip 44094 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384790 | Kimberly Chmielewski | Nurse Practitioner | 3422 Cross Creek Cir, Wooster, OH 44691-1861 | 2020-10-21 |
| 1649877077 | Lee Danielle Watts | Nurse Practitioner | 2152 E State Route 29, Urbana, OH 43078-9779 | 2020-10-08 |
| 1003425281 | Jessica Shattuck | Nurse Practitioner | 108 Slippery Rock Ln, Berea, OH 44017-3155 | 2020-07-23 |
| 1205460060 | Katherine Niles | Nurse Practitioner | 7884 Oak Valley Rd, Reynoldsburg, OH 43068-1577 | 2020-03-02 |
| 1447803267 | Amy Kathleen Mock | Nurse Practitioner | 575 Westar Xing Ste 102, Westerville, OH 43082-7815 | 2019-07-21 |
| 1659933729 | Ashley Marie Brown | Nurse Practitioner | 2055 Crocker Rd Ste 206, Westlake, OH 44145-2197 | 2019-06-28 |
| 1144881772 | Erin Burris | Nurse Practitioner | 201 5th St Ne Ste 15, Barberton, OH 44203-3017 | 2019-06-25 |
| 1326604299 | Tiffany Messerall | Nurse Practitioner | 1577 Guilford Rd, Columbus, OH 43221-3850 | 2019-05-15 |
| 1093298689 | Jennifer Emrick | Nurse Practitioner | 3909 Orange Pl Ste 4400, Beachwood, OH 44122-4482 | 2018-09-11 |
| 1730661703 | Lisa Taormina-dingman | Nurse Practitioner | 7067 Tiffany Blvd Ste 220, Poland, OH 44514-1981 | 2018-09-05 |
| Find all providers with the same taxonomy | ||||
| City | WILLOUGHBY |
| Zip Code | 44094 |
Please comment or provide details below to improve the information on MRS. STACY RUTH ROSE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.