Healthcare Provider Details

I. General information

NPI: 1831976471
Provider Name (Legal Business Name): JOSEPH NANAMAKER I CPRS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2023
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 CARLIN ST
FINDLAY OH
45840-1460
US

IV. Provider business mailing address

2205 N BLANCHARD ST UNIT 105
FINDLAY OH
45840-4524
US

V. Phone/Fax

Practice location:
  • Phone: 419-425-5050
  • Fax:
Mailing address:
  • Phone: 419-672-1792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberAPS.004332
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: