Provider Demographics
NPI:1992919807
Name:KLING, STACY LYNN (HOME HEALTH CARE)
Entity type:Individual
Prefix:MS
First Name:STACY
Middle Name:LYNN
Last Name:KLING
Suffix:
Gender:F
Credentials:HOME HEALTH CARE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-2557
Mailing Address - Country:US
Mailing Address - Phone:740-622-0447
Mailing Address - Fax:
Practice Address - Street 1:679 JOHN ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-2557
Practice Address - Country:US
Practice Address - Phone:740-622-0447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2460322OtherPROVIDER NUMBER