Provider Demographics
NPI:1235833393
Name:TUSTIN, PAIGE RHYAN
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:RHYAN
Last Name:TUSTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2819 OBERLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-4558
Mailing Address - Country:US
Mailing Address - Phone:304-551-6666
Mailing Address - Fax:
Practice Address - Street 1:48090 COOPER FOSTER PARK RD # 44001
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-3324
Practice Address - Country:US
Practice Address - Phone:440-315-5876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide