Healthcare Provider Details

I. General information

NPI: 1780501916
Provider Name (Legal Business Name): MARY TRUSTER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 N LOCUST ST STE A
OXFORD OH
45056-1182
US

IV. Provider business mailing address

PO BOX 837
HAMILTON OH
45012-0837
US

V. Phone/Fax

Practice location:
  • Phone: 513-454-1111
  • Fax:
Mailing address:
  • Phone: 513-820-0432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0042560
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: