Healthcare Provider Details

I. General information

NPI: 1851983647
Provider Name (Legal Business Name): HALEI R STEBBINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2021
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5450 DETROIT AVE
CLEVELAND OH
44102-3036
US

IV. Provider business mailing address

5450 DETROIT AVE
CLEVELAND OH
44102-3036
US

V. Phone/Fax

Practice location:
  • Phone: 216-377-1778
  • Fax:
Mailing address:
  • Phone: 216-377-1778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0027629
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: