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MRS. STACY RUTH ROSE CRNP
NPI 1689658031
Nurse Practitioner - Women's Health in Willoughby, OH

Active since November 30, 2005
4176 STATE ROUTE 306, WILLOUGHBY, OH 44094(440) 918-4630(440) 918-4620 Get Directions Write a Review

NPPES record last updated: March 3, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 3, 2021, Jun 9, 2017 (2 updates tracked since 2017).

About Mrs. Stacy Ruth Rose Crnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. STACY RUTH ROSE CRNP (NPI 1689658031) is an individual women's health provider in Willoughby, Ohio, licensed in Ohio (COA.06089-NP) and active in the NPI registry since November 2005.

NPPES Registry Identity

NPI1689658031
Entity TypeIndividualFemale
Primary Taxonomy363LW0102X
Provider Legal NameMRS. STACY RUTH ROSECredential: CRNP
Location Address4176 STATE ROUTE 306Willoughby, OH 44094-9203
Mailing Address7590 Auburn Road, Suite 014, Attn: Med StaffConcord Twp, OH 44077-9176 · (440) 354-1899 · Fax (440) 354-1845
Phone(440) 918-4630
Fax(440) 918-4620
Sole ProprietorNo
Enumeration DateNovember 30, 2005
Last NPPES UpdateMarch 3, 20212 updates tracked since enumeration
NPPES CertifiedMarch 3, 2021
✔ NPI 1689658031 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LW0102X
License✔ Licensed in OH · COA.06089-NP
4176 STATE ROUTE 306, Willoughby, OH 44094
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Other Identifiers 2

Medicaid2203627OH
OtherH020110OH · Medicare

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JANIE M ZART MD
Obstetrics & Gynecology
4176 STATE ROUTE 306
WILLOUGHBY, OH 44094
Lake County (440) 918-4630
THOMESHA MARIE BARTON MD
Obstetrics & Gynecology
4176 STATE ROUTE 306
WILLOUGHBY, OH 44094
Lake County (440) 918-4630
LIESE K VITO MD
Obstetrics & Gynecology
4176 STATE ROUTE 306
WILLOUGHBY, OH 44094
Lake County (440) 918-4630
CYNTHIA R BOES MD
Obstetrics & Gynecology
4176 STATE ROUTE 306
WILLOUGHBY, OH 44094
Lake County (440) 918-4630
NEELIMA D RAO
Internal Medicine
4176 STATE ROUTE 306
WILLOUGHBY, OH 44094
Lake County (440) 918-4600
AMY MARIE LIVINGSTON ANP
Nurse Practitioner (Adult Health)
4176 STATE ROUTE 306
WILLOUGHBY, OH 44094
Lake County (440) 918-4690
DR. SHANNON CHARISSE GILHAM DO
Obstetrics & Gynecology
4176 STATE ROUTE 306
WILLOUGHBY, OH 44094
Lake County (440) 918-4630
WENDY J CLINGER MD
Obstetrics & Gynecology
4176 STATE ROUTE 306
WILLOUGHBY, OH 44094
Lake County (440) 918-4630

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacy Rose's NPI number?

The NPI number for Stacy Rose is 1689658031. It was assigned to this individual provider in the NPPES registry on November 30, 2005.

Where is Stacy Rose located?

Stacy Rose practices at 4176 State Route 306, Willoughby, OH 44094. The listed phone number is (440) 918-4630.

What is Stacy Rose's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

When was this NPI record last updated?

The NPPES record for Stacy Rose was last updated on March 3, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.