Individual
MARYPAT PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
30000 E RIVER RD, PERRYSBURG, OH 43551-3429
(419) 661-4001
(419) 661-4015
Mailing address
30000 E RIVER RD, PERRYSBURG, OH 43551-3429
(419) 661-4001
(419) 878-8515
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN.CNP022190
OH
363LG0600X
Gerontology Nurse Practitioner
APRN.CNP022190
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0261012
—
OH
Enumeration date
01/16/2018
Last updated
05/20/2022
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