Healthcare Provider Details

I. General information

NPI: 1093651135
Provider Name (Legal Business Name): GENNA PEACE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ARLINGTON AVE
TOLEDO OH
43614-2598
US

IV. Provider business mailing address

914 E SOUTH RANGE RD
NORTH LIMA OH
44452-9753
US

V. Phone/Fax

Practice location:
  • Phone: 419-383-4000
  • Fax:
Mailing address:
  • Phone: 330-921-5634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.473295
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: