Individual provider · NPI-1

Stacy Nicole Henry

Nurse Practitioner, Family · Twinsburg, OH

NPI number1972815520
StatusActive
Last updated in NPPESJul 12, 2010

Details

NPI
1972815520
Entity type
Individual (NPI-1)
Name
Stacy Nicole Henry
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 12, 2010
Last updated
Jul 12, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyCOA.11572-NPOHYes

Practice location

10085 Darrow Rd
Twinsburg, OH 44087-1409

Phone 866-389-2727

Mailing address

5113 Quail Hill St Nw Apt E
North Canton, OH 44720-8406

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