Individual
SUSAN MAHONEY STOMBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4235 SECOR RD, TOLEDO, OH 43623
(419) 479-5605
Mailing address
4235 SECOR RD, TOLEDO, OH 43623
(419) 479-5605
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NP02288
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2524441
—
OH
Enumeration date
03/21/2006
Last updated
05/31/2011
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