Healthcare Provider Details

I. General information

NPI: 1316471055
Provider Name (Legal Business Name): VERONICA MARIE PAINTER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VERONICA MARIE ROCK CNP

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E WASHINGTON ST
MEDINA OH
44256-2170
US

IV. Provider business mailing address

1000 EAST WASHINGTON ST.
MEDINA OH
44256
US

V. Phone/Fax

Practice location:
  • Phone: 330-725-1000
  • Fax:
Mailing address:
  • Phone: 440-465-6287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.020728
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: