Individual
MRS. PATRICIA HELEN FAIRTILE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
335 GLESSNER AVE, MANSFIELD, OH 44903-2269
(419) 526-8355
Mailing address
930 27TH ST NE, MASSILLON, OH 44646-2983
(330) 830-8833
(330) 830-8833
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN140343 NA00548
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
641005
—
OH
Enumeration date
09/05/2005
Last updated
07/08/2007
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