Provider Demographics
NPI:1588052757
Name:SWINDELL, STACEY E (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:E
Last Name:SWINDELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 W MARKET ST STE 210
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-4234
Mailing Address - Country:US
Mailing Address - Phone:330-344-1382
Mailing Address - Fax:330-344-1077
Practice Address - Street 1:2603 W MARKET ST STE 210
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-4234
Practice Address - Country:US
Practice Address - Phone:330-344-1382
Practice Address - Fax:330-344-1077
Is Sole Proprietor?:No
Enumeration Date:2014-12-22
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.16621-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0122892Medicaid
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OHH270430Medicare PIN