Healthcare Provider Details

I. General information

NPI: 1427969112
Provider Name (Legal Business Name): STACI MARIE MUETZEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2658 N COLUMBUS ST STE C
LANCASTER OH
43130-8796
US

IV. Provider business mailing address

1195 TOMMY BEEN RD
OAK HILL OH
45656-9784
US

V. Phone/Fax

Practice location:
  • Phone: 740-277-6269
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.416067
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: