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General NPI Number Information
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NPI Number | 1043979255
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Entity Type | Individual
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Provider Name | BEVERLY FOLTZ NP
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Gender | Female
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Dates
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Enumeration Date | 12/15/2021
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 2751 BAY PARK DR STE 302
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City | OREGON
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State | OH
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Zip | 43616-4922
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Country | US
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Telephone | 419-690-7686
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Fax |
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Provider Business Mailing Address
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Address Line | 28963 BELMONT FARM RD
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City | PERRYSBURG
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State | OH
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Zip | 43551-3795
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | LE-00036812
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License Number State | OH
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