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General NPI Number Information
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NPI Number | 1730706664
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Entity Type | Individual
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Provider Name | MALLORY DAWN CAPRETTA CPNP-PC
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Gender | Female
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Dates
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Enumeration Date | 06/26/2020
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Last Update Date | 04/29/2021
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Provider Practice Location Address
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Address Line | 6505 MARKET ST
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City | BOARDMAN
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State | OH
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Zip | 44512-3457
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Country | US
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Telephone | 330-729-7633
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Fax | 330-729-7656
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Provider Business Mailing Address
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Address Line | 1 PERKINS SQ
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City | AKRON
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State | OH
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Zip | 44308-1063
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Country | US
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Telephone | 330-376-3332
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0027093
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 345985
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0027093
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License Number State | OH
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