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General NPI Number Information
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NPI Number | 1831933548
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Entity Type | Organization
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Legal Business Name | PLATINUM HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 06/19/2024
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 22610 LORAIN RD STE UR
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City | FAIRVIEW PARK
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State | OH
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Zip | 44126-2214
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Country | US
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Telephone | 330-421-2291
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Fax |
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Provider Business Mailing Address
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Address Line | 22610 LORAIN RD STE UR
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City | FAIRVIEW PARK
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State | OH
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Zip | 44126-2214
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Country | US
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Telephone | 330-421-2291
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MR. SCOTT A STICKNEY JR.
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Credential | APRN
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Telephone | 330-421-2291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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