Healthcare Provider Details

I. General information

NPI: 1285132951
Provider Name (Legal Business Name): VALERIE R. PINGLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3224 JARVIS RD
LIMA OH
45807-2213
US

IV. Provider business mailing address

770 W HIGH ST STE 350
LIMA OH
45801-5901
US

V. Phone/Fax

Practice location:
  • Phone: 419-996-5757
  • Fax: 419-996-5913
Mailing address:
  • Phone: 419-228-8950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRNCNP021887
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: