Provider Demographics
NPI:1275949851
Name:MAXEY, JANICE RUTH (NP-C)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:RUTH
Last Name:MAXEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:RUTH
Other - Last Name:WAGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30000 E RIVER RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-3429
Mailing Address - Country:US
Mailing Address - Phone:419-661-4001
Mailing Address - Fax:419-661-4015
Practice Address - Street 1:30000 E RIVER RD
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-3429
Practice Address - Country:US
Practice Address - Phone:419-661-4001
Practice Address - Fax:419-661-4015
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF0614282363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily