Healthcare Provider Details

I. General information

NPI: 1902466147
Provider Name (Legal Business Name): STACY SCHOCH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STACY HONAKER RN

II. Dates (important events)

Enumeration Date: 06/19/2019
Last Update Date: 06/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 HAYES AVE
SANDUSKY OH
44870-4737
US

IV. Provider business mailing address

1925 HAYES AVE
SANDUSKY OH
44870-4737
US

V. Phone/Fax

Practice location:
  • Phone: 419-557-5177
  • Fax: 419-557-5179
Mailing address:
  • Phone: 419-557-5177
  • Fax: 419-557-5179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN439567
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: