Individual
MIA BAUSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
733 MARKET AVE S, CANTON, OH 44702-2165
(216) 302-5747
Mailing address
733 MARKET AVE S, CANTON, OH 44702-2165
(216) 302-5747
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
223516
OH
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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