Healthcare Provider Details

I. General information

NPI: 1851543482
Provider Name (Legal Business Name): MARIA ANTOINETTE MATHIS APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2008
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5954 BLOSSMAN RD
TOLEDO OH
43617-1002
US

IV. Provider business mailing address

5954 BLOSSMAN RD
TOLEDO OH
43617-1002
US

V. Phone/Fax

Practice location:
  • Phone: 419-672-9195
  • Fax:
Mailing address:
  • Phone: 419-672-9195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0034021
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN310985
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: