Provider Demographics
NPI:1619103744
Name:SWEENY, STEPHANIE MONDO (CNP)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:MONDO
Last Name:SWEENY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3685 WINDSONG CT
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5484
Mailing Address - Country:US
Mailing Address - Phone:440-779-1682
Mailing Address - Fax:
Practice Address - Street 1:4041 NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND HILLS
Practice Address - State:OH
Practice Address - Zip Code:44122-7001
Practice Address - Country:US
Practice Address - Phone:216-765-6968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08351363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily