Provider Demographics
NPI:1972193100
Name:RAPTON, PAMELA SUE
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:SUE
Last Name:RAPTON
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 1:330 W. CRAWFORD AVE.
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-3451
Mailing Address - Country:US
Mailing Address - Phone:352-410-0153
Mailing Address - Fax:
Practice Address - Street 1:330 W. CRAWFORD AVE.
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-3451
Practice Address - Country:US
Practice Address - Phone:352-410-0153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9100166760Medicaid
OH4810251OtherDODD