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General NPI Number Information
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NPI Number | 1902413677
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Entity Type | Individual
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Provider Name | STACEY BRIND APN
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Gender | Female
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Dates
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Enumeration Date | 09/28/2020
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 4242 STATE ROUTE 306
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City | KIRTLAND
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State | OH
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Zip | 44094-9204
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Country | US
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Telephone | 440-578-8200
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Fax | 440-918-3839
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Provider Business Mailing Address
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Address Line | 4242 STATE ROUTE 306
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City | KIRTLAND
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State | OH
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Zip | 44094-9204
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Country | US
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Telephone | 440-578-8200
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Fax | 440-918-3839
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | RN412520
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.412510
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0039643
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License Number State | OH
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