Provider Demographics
NPI:1851856264
Name:ADAMS, STACY LOUISE (RN)
Entity Type:Individual
Prefix:MS
First Name:STACY
Middle Name:LOUISE
Last Name:ADAMS
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 1:87 CONSERVATORY DR
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-4291
Mailing Address - Country:US
Mailing Address - Phone:234-334-0303
Mailing Address - Fax:
Practice Address - Street 1:87 CONSERVATORY DR
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-4291
Practice Address - Country:US
Practice Address - Phone:234-334-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.456536163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)