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Individual
MARY ELIZABETH GAINES
Active
Individual
MARY ELIZABETH GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN.254604
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074861
ODADAS---CD
OH
01
—
0074946
ODMH
OH
01
—
01-0693
CARF CERTIFICATION
OH
01
—
H130910
MEDICARE GROUP PTAN
OH
Enumeration date
09/28/2016
Last updated
02/08/2017
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