Provider Demographics
NPI:1093356669
Name:STALCUP, LEBERLIZA (RN)
Entity Type:Individual
Prefix:MRS
First Name:LEBERLIZA
Middle Name:
Last Name:STALCUP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 765
Mailing Address - Street 2:
Mailing Address - City:GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:44232-0765
Mailing Address - Country:US
Mailing Address - Phone:330-212-5554
Mailing Address - Fax:
Practice Address - Street 1:5458 FULTON RD, CANTON OHIO 44718
Practice Address - Street 2:SUITE B
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718
Practice Address - Country:US
Practice Address - Phone:330-465-4987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.434933163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse