Provider Demographics
NPI:1144246570
Name:YURSKY, MARY E (CNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:YURSKY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32800 LORAIN RD STE 2300
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-3430
Mailing Address - Country:US
Mailing Address - Phone:440-406-5500
Mailing Address - Fax:440-406-5501
Practice Address - Street 1:32800 LORAIN RD
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-3430
Practice Address - Country:US
Practice Address - Phone:440-406-5500
Practice Address - Fax:440-406-5501
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN229227163WG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0100XNursing Service ProvidersRegistered NurseGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2207801Medicaid
000000224430OtherUNISON
7454595OtherAETNA
000000539713OtherANTHEM
751193OtherBUCKEYE
364161OtherWELLCARE
P01459Medicare UPIN
OHYUNP05282Medicare PIN
YUNP05283Medicare PIN
364161OtherWELLCARE