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NPI Code Detail

MEDICARE: MRS. STACEY LYNN BISLER-THEUS FNP-C

MEDICARE: MRS. STACEY LYNN BISLER-THEUS FNP-C
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
1363LP2300XPrimary Care Nurse PractitionerF01240991OH

General Provider Information

NPI Number : 1821819269
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STACEY LYNN BISLER-THEUS FNP-C
Provider Business Mailing Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-6114
Country : US
Telephone Number : 440-503-4619
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-645-4282
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2024
Last Update Date : 01/07/2025

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