Healthcare Provider Details
I. General information
NPI: 1063124741
Provider Name (Legal Business Name): ESSENCE N HULSINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/14/2022
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3922 LOVERS LN
RAVENNA OH
44266-4200
US
IV. Provider business mailing address
5982 RHODES RD
KENT OH
44240-8100
US
V. Phone/Fax
- Phone: 800-673-1347
- Fax:
- Phone: 330-673-1347
- Fax: 330-678-3677
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: