Provider Demographics
NPI:1922060375
Name:STACKS, LINDSEY RENEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:RENEE
Last Name:STACKS
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 1:937 PRATT AVE
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3023
Mailing Address - Country:US
Mailing Address - Phone:330-687-3522
Mailing Address - Fax:
Practice Address - Street 1:937 PRATT AVE
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3023
Practice Address - Country:US
Practice Address - Phone:330-687-3522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2016-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN408836163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2489070Medicaid