Radvansky, Mallory
Radvansky, Mallory is an individual health care provider with primary practice located at 425 W 5Th St , East Liverpool OH 43920-2405. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Radvansky, Mallory can be contacted via phone (330) 386-5279.Contact Information
Primary practice address
425 W 5Th St
East Liverpool OH 43920-2405
Phone: (330) 386-5279
Fax: (330) 386-5866
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | SP015019 | Pennsylvania |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | APRN.CNP.14103 | Ohio |
Profile Details
| NPI number | 1376881607 |
|---|---|
| LBN Legal business name | Radvansky, Mallory |
| Credentials | Certified Family Nurse Practitioner (CFNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 22nd, 2013 |
| Last updated | Jan 25th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376881607 | NPPES |
| Ohio | Other | P01326293 | RR MEDICARE |
| Ohio | MEDICAID | 0079443 | RR MEDICARE |
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