Healthcare Provider Details

I. General information

NPI: 1790735462
Provider Name (Legal Business Name): VISITING NURSE ASSOCIATION OF MID-OHIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 W 4TH ST
MANSFIELD OH
44902-1206
US

IV. Provider business mailing address

925 KEYNOTE CIR STE 300
BROOKLYN HEIGHTS OH
44131-1869
US

V. Phone/Fax

Practice location:
  • Phone: 419-522-4969
  • Fax: 216-694-4162
Mailing address:
  • Phone: 216-694-4232
  • Fax: 216-694-4162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateOH

VIII. Authorized Official

Name: LISA KRISTOSIK
Title or Position: PRESIDENT
Credential: MSN, RN
Phone: 216-902-7902