Healthcare Provider Details

I. General information

NPI: 1144246570
Provider Name (Legal Business Name): MARY E YURSKY CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 11/19/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32800 LORAIN RD
NORTH RIDGEVILLE OH
44039-3430
US

IV. Provider business mailing address

32800 LORAIN RD STE 2300
NORTH RIDGEVILLE OH
44039-3430
US

V. Phone/Fax

Practice location:
  • Phone: 440-406-5500
  • Fax: 440-406-5501
Mailing address:
  • Phone: 440-406-5500
  • Fax: 440-406-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0100X
TaxonomyGastroenterology Registered Nurse
License NumberRN229227
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: