Healthcare Provider Details

I. General information

NPI: 1831218288
Provider Name (Legal Business Name): MARY FOLGER R.N.C.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 03/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6140 S BROADWAY
LORAIN OH
44053-3821
US

IV. Provider business mailing address

6140 S BROADWAY
LORAIN OH
44053-3821
US

V. Phone/Fax

Practice location:
  • Phone: 440-204-4100
  • Fax: 440-233-4468
Mailing address:
  • Phone: 440-233-7232
  • Fax: 440-233-9070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberCOA02471NS
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN-172780
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: