Provider Demographics
NPI:1598213720
Name:SCHUERMAN, STACIE (PA)
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:
Last Name:SCHUERMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:STACIE
Other - Middle Name:
Other - Last Name:CHANDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:803 W MARKET ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-2796
Mailing Address - Country:US
Mailing Address - Phone:419-222-3737
Mailing Address - Fax:419-229-3234
Practice Address - Street 1:803 W MARKET ST STE 200
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-2796
Practice Address - Country:US
Practice Address - Phone:419-222-3737
Practice Address - Fax:419-229-3234
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50004783RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0188686Medicaid
OH0188686Medicaid