Provider Demographics
NPI:1073551941
Name:ABERCROMBIE, MARY G (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:G
Last Name:ABERCROMBIE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 VALENTINE FARMS LN
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2250
Mailing Address - Country:US
Mailing Address - Phone:330-665-3321
Mailing Address - Fax:330-665-3959
Practice Address - Street 1:270 VALENTINE FARMS LN
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-2250
Practice Address - Country:US
Practice Address - Phone:330-665-3321
Practice Address - Fax:330-665-3959
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.266952163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2248535Medicaid