IndividualActive
Charlie Stacy
NPI 1013206374 · Licensed Practical Nurse · Rootstown, OH
Provider details
- NPI number
- 1013206374
- Entity type
- Individual
- Primary specialty
- Licensed Practical NurseNursing Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- PN 142404 (OH)
Specialties & taxonomies
Nursing Service Providers
Practice location
4014 Bower Rd
Rootstown, OH 44272-9231
Phone: (330) 325-7636
Approximate (ZIP-level) locationGet directions
Mailing address
4014 Bower Rd
Rootstown, OH 44272-9231
Registry dates
- Enumerated
- 2011-04-06
- Last updated
- 2011-04-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.