Provider Demographics
NPI:1598524589
Name:NOTTINGHAM, STACY LIN
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:LIN
Last Name:NOTTINGHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7044 STREETER RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:OH
Mailing Address - Zip Code:44288-9743
Mailing Address - Country:US
Mailing Address - Phone:330-819-3951
Mailing Address - Fax:
Practice Address - Street 1:7044 STREETER RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:OH
Practice Address - Zip Code:44288-9743
Practice Address - Country:US
Practice Address - Phone:330-819-3951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care