Provider Demographics
NPI:1306051271
Name:STAUBS, AMY LYNN
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:STAUBS
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 1:479 MANDERLY DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-6640
Mailing Address - Country:US
Mailing Address - Phone:330-864-5017
Mailing Address - Fax:
Practice Address - Street 1:1338 FOREST GLEN DR
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-4846
Practice Address - Country:US
Practice Address - Phone:330-352-2540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2708716Medicare ID - Type UnspecifiedHOME AIDE