# PREMIER PRACTITIONERS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831240381
- **Authorized official:** MRS. KELLY A SHANK NP (OWNER)
- **Authorized official phone:** (419) 266-5762

## Contact information

- **Practice address:** 22650 AULT RD, PERRYSBURG, OH 43551-8953
- **Practice address phone:** (419) 266-5762
- **Practice address fax:** (419) 833-1123
- **Mailing address:** 22650 AULT RD, PERRYSBURG, OH 43551-8953
- **Mailing address phone:** (419) 266-5762
- **Mailing address fax:** (419) 833-1123

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | NP03335 | OH | Yes |

## Other

- **Enumeration date:** 01/12/2007
- **Last updated:** 08/22/2020