Individual
ELIZABETH MUSOLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
22614 W STATE ROUTE 51, GENOA, OH 43430-1143
(419) 855-7772
(419) 855-4800
Mailing address
PO BOX 378, SANDUSKY, OH 44871-0378
(419) 609-1112
(419) 609-1123
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
05183
OH
363L00000X
Nurse Practitioner
Primary
COA-05183-NP
OH
363LP0200X
Pediatric Nurse Practitioner
COA.05183-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2196243
—
OH
05
—
4664546
—
MI
Enumeration date
07/22/2005
Last updated
10/17/2022
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