Healthcare Provider Details

I. General information

NPI: 1053265181
Provider Name (Legal Business Name): JUSTIN A. WAYS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7140 PORT SYLVANIA DR
TOLEDO OH
43617-1176
US

IV. Provider business mailing address

3909 WOODLEY RD
TOLEDO OH
43606-1169
US

V. Phone/Fax

Practice location:
  • Phone: 567-408-7242
  • Fax:
Mailing address:
  • Phone: 419-475-4449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0041557
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: