Individual provider · Type 1 NPI
Stacy M. Speck, RD, RN, APN
Pediatric Nurse Practitioner · Cleveland, OH
NPI number
1366642860
Active
Practice location
11100 Euclid Ave Rm B501
Cleveland, OH 44106-1716
Fax (216) 844-5710
Mailing address
1500 Detroit Ave Apt 618
Cleveland, OH 44113-2448
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 209006587 (IL) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | .0032134 (OH) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1366642860
Stacy M. Speck, RD, RN, APN's National Provider Identifier is 1366642860, issued on Jul 23, 2007. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Cleveland, OH. The record was last updated on Nov 18, 2022.