Healthcare Provider Details

I. General information

NPI: 1033524954
Provider Name (Legal Business Name): MAETINEE LOPARO NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 06/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13207 RAVENNA RD
CHARDON OH
44024-7032
US

IV. Provider business mailing address

5700 DARROW RD SUITE 106
HUDSON OH
44236-5026
US

V. Phone/Fax

Practice location:
  • Phone: 330-656-9304
  • Fax:
Mailing address:
  • Phone: 330-656-9304
  • Fax: 330-656-5901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.323310-COA1
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCOA.16115-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: