Provider Demographics
NPI:1316549561
Name:ENDSLEY, PAIGE E
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:E
Last Name:ENDSLEY
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 1:455 CLARIDON AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-5603
Mailing Address - Country:US
Mailing Address - Phone:740-262-1812
Mailing Address - Fax:
Practice Address - Street 1:2642 OWENS GREEN CAMP RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-8820
Practice Address - Country:US
Practice Address - Phone:740-262-1812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant