MEDICARE: CHRISTINA E STOUT NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	NP07951	OH
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NP07951	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083691851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA E STOUT NP

Provider Business Mailing Address
First Line	:	1739 CLEVELAND RD
Second Line	:
City	:	WOOSTER
State	:	OH
Zip	:	44691-2203
Country	:	US
Telephone Number	:	330-262-2500
Fax Number	:	330-264-8713

Provider Business Practice Location Address
First Line	:	1739 CLEVELAND RD
Second Line	:
City	:	WOOSTER
State	:	OH
Zip	:	44691-2203
Country	:	US
Telephone Number	:	330-262-2500
Fax Number	:	330-264-8713

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	06/15/2022

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