Provider Demographics
NPI:1699723288
Name:CLAYPOOLE, BOBBI SUE (CNM)
Entity type:Individual
Prefix:
First Name:BOBBI
Middle Name:SUE
Last Name:CLAYPOOLE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:BOBBI
Other - Middle Name:SUE
Other - Last Name:WIGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:1 PARK WEST BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-4219
Mailing Address - Country:US
Mailing Address - Phone:330-869-9777
Mailing Address - Fax:330-869-0052
Practice Address - Street 1:1 PARK WEST BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-4219
Practice Address - Country:US
Practice Address - Phone:330-869-9777
Practice Address - Fax:330-869-0052
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNM05908367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2236459Medicaid
OH2236459Medicaid