Healthcare Provider Details

I. General information

NPI: 1881990174
Provider Name (Legal Business Name): MICHELLE LYNN EGLER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2011
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 RALSTON AVE STE 104
DEFIANCE OH
43512-5308
US

IV. Provider business mailing address

100 MADISON AVE
TOLEDO OH
43604-1516
US

V. Phone/Fax

Practice location:
  • Phone: 419-785-3281
  • Fax: 419-782-6453
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN304870
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number021447
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: