Healthcare Provider Details

I. General information

NPI: 1104730225
Provider Name (Legal Business Name): MARY JANE PADILLA BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8595 WRENFORD CT
MACEDONIA OH
44056-1750
US

IV. Provider business mailing address

8595 WRENFORD CT
MACEDONIA OH
44056-1750
US

V. Phone/Fax

Practice location:
  • Phone: 216-246-4631
  • Fax:
Mailing address:
  • Phone: 216-246-4631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberRN.322281
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: