Provider Demographics
NPI:1720530181
Name:FAST RESPONSE NURSE PRACTITIONERS, LLC
Entity Type:Organization
Organization Name:FAST RESPONSE NURSE PRACTITIONERS, LLC
Other - Org Name:WELLSPRING NURSE PRACTITIONERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:TOETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-930-6686
Mailing Address - Street 1:3905 OBERLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-2853
Mailing Address - Country:US
Mailing Address - Phone:440-541-7790
Mailing Address - Fax:440-333-2935
Practice Address - Street 1:3905 OBERLIN AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-2853
Practice Address - Country:US
Practice Address - Phone:440-989-5200
Practice Address - Fax:440-299-6401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2023-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0193892Medicaid