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NPI Code Detail

MEDICARE: MS. CHRISTINE A UTLEY M.S.N., NP

MEDICARE: MS. CHRISTINE A UTLEY M.S.N., NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN171234OH
2363L00000XNurse PractitionerCOA.07625-NPOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457347528
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHRISTINE A UTLEY M.S.N., NP
Provider Business Mailing Address
First Line : 3355 GLENDALE AVE FL 3
Second Line :
City : TOLEDO
State : OH
Zip : 43614-2426
Country : US
Telephone Number : 419-291-3900
Fax Number : 419-479-6055
Provider Business Practice Location Address
First Line : 2130 W CENTRAL AVE STE 201
Second Line :
City : TOLEDO
State : OH
Zip : 43606-3819
Country : US
Telephone Number : 419-291-3900
Fax Number : 419-479-6055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 05/23/2018

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