Provider Demographics
NPI:1851789895
Name:KREGEL, STACIE (CNP)
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:
Last Name:KREGEL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 HUGHES DR STE 760
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-5111
Mailing Address - Country:US
Mailing Address - Phone:419-479-2676
Mailing Address - Fax:419-479-2696
Practice Address - Street 1:2109 HUGHES DR STE 760
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-5111
Practice Address - Country:US
Practice Address - Phone:419-479-2676
Practice Address - Fax:419-479-2696
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-29
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.16894-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily