Individual
MRS. GINA MARIE MODENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
141 N FORGE ST STE 400, AKRON, OH 44304
(330) 375-7494
(330) 375-7499
Mailing address
875 N. MUNROE RD, TALLMADGE, OH 44278
(330) 715-8486
(330) 375-7499
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
10791
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
0357076-21
OH
363LA2200X
Adult Health Nurse Practitioner
10791
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05181-RX
CERTIFICATE TO PRESCRIBE
OH
05
—
2907457
—
OH
Enumeration date
03/15/2007
Last updated
03/12/2025
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