MEDICARE: STEPHANIE CORAZZOL NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	4704367788	MI
2	363LF0000X	Family Nurse Practitioner	0039940	OH

General Provider Information

NPI Number	:	1245102821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE CORAZZOL NP

Provider Business Mailing Address
First Line	:	12780 ROACHTON RD
Second Line	:
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-1350
Country	:	US
Telephone Number	:	419-872-0777
Fax Number	:	419-872-2369

Provider Business Practice Location Address
First Line	:	12780 ROACHTON RD
Second Line	:
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-1350
Country	:	US
Telephone Number	:	419-872-0777
Fax Number	:	419-872-2369

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2025
Last Update Date	:	06/01/2026

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Directions to “ STEPHANIE CORAZZOL NP” Practice Location

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