Healthcare Provider Details

I. General information

NPI: 1821900093
Provider Name (Legal Business Name): ELIZABETH KAY PAGLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 SUMMIT DR
CANFIELD OH
44406-9510
US

IV. Provider business mailing address

777 WILDWOOD DR
YOUNGSTOWN OH
44512-3242
US

V. Phone/Fax

Practice location:
  • Phone: 330-759-3903
  • Fax:
Mailing address:
  • Phone: 330-883-1280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0043391
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: