Healthcare Provider Details

I. General information

NPI: 1164840765
Provider Name (Legal Business Name): PAULA ELIZABETH SOERGEL CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULA ELIZABETH SOERGEL CNP

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 04/26/2021
Certification Date: 04/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 BELMONT AVE
YOUNGSTOWN OH
44504-1006
US

IV. Provider business mailing address

1044 BELMONT AVE
YOUNGSTOWN OH
44504-1006
US

V. Phone/Fax

Practice location:
  • Phone: 330-480-3258
  • Fax: 330-480-4119
Mailing address:
  • Phone: 330-480-3258
  • Fax: 330-480-4119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0028797
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024175890
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: