Provider Demographics
NPI:1154542660
Name:STACKHOUSE-ROBY, LYNN ANNE (APRN, DNP)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:ANNE
Last Name:STACKHOUSE-ROBY
Suffix:
Gender:F
Credentials:APRN, DNP
Other - Prefix:MS
Other - First Name:LYNN
Other - Middle Name:ANNE
Other - Last Name:STACKHOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:9323 SAYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-8748
Mailing Address - Country:US
Mailing Address - Phone:440-667-4511
Mailing Address - Fax:
Practice Address - Street 1:1111 HAYES AVE
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-3323
Practice Address - Country:US
Practice Address - Phone:419-557-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.09403-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health