Provider Demographics
NPI:1316326390
Name:METZLER, PATRICIA DIANE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:DIANE
Last Name:METZLER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14137 MAHONING AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:44451-9616
Mailing Address - Country:US
Mailing Address - Phone:330-469-1185
Mailing Address - Fax:
Practice Address - Street 1:5701 BURNETT RD
Practice Address - Street 2:
Practice Address - City:LEAVITTSBURG
Practice Address - State:OH
Practice Address - Zip Code:44430-9713
Practice Address - Country:US
Practice Address - Phone:330-898-0820
Practice Address - Fax:330-898-9771
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-25
Last Update Date:2019-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.16000-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health