Doctor Name: | MANDI L. FILLA |
NPI Number: | 1144629429 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNP |
License Number: | COA.16305-NP |
Business Practice Address: | 2971 Graham Rd Stow, OH - 442243619 |
Business Phone Number: | 3306887981 |
Business Fax Number: | 3306887469 |
Mailing Address: | 2971 Graham Rd, STOW |
State: | OH |
Postal Code: | 442243619 |
Phone Number: | 3306887981 |
Fax Number: | 3306887469 |
NPI Enumeration Date: | 08/22/2014 |
NPI Last Update Date: | 08/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | COA.16305-NP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |