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General NPI Number Information
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NPI Number | 1811399637
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Entity Type | Individual
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Provider Name | MARY LYNNE GARRETT
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Gender | Female
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Dates
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Enumeration Date | 09/24/2014
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Last Update Date | 09/24/2014
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Provider Practice Location Address
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Address Line | 1397 WALNUT ST
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City | COSHOCTON
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State | OH
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Zip | 43812-2238
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Country | US
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Telephone | 740-623-4382
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Fax | 740-622-1283
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Provider Business Mailing Address
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Address Line | 5697 TAYLOR RD
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City | NEW FRANKLIN
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State | OH
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Zip | 44216-9330
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Country | US
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Telephone | 330-338-2864
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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 | COA16565NP
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License Number State | OH
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