| NPI | 1013028406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY NELSON Director 330-884-4850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 207X00000X Orthopaedic Surgery | |
| 208000000X Pediatrics | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 208600000X Surgery | |
| 2086S0127X Surgery, Trauma Surgery | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-09-11 |