Provider Demographics
NPI:1306354576
Name:STROBLE, NATHAN K (CNP)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:K
Last Name:STROBLE
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 STARR AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43605-2456
Mailing Address - Country:US
Mailing Address - Phone:419-936-7600
Mailing Address - Fax:419-936-7606
Practice Address - Street 1:544 E WOODRUFF AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-5342
Practice Address - Country:US
Practice Address - Phone:419-936-7600
Practice Address - Fax:419-936-7606
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029954363LP0808X
OHRN.435589163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0259056Medicaid