Provider Demographics
NPI:1720479850
Name:EBERSOLE, CAROL MARIE (CNP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:MARIE
Last Name:EBERSOLE
Suffix:
Gender:
Credentials:CNP
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:MARIE
Other - Last Name:VERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7620 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-9449
Mailing Address - Country:US
Mailing Address - Phone:419-306-2376
Mailing Address - Fax:
Practice Address - Street 1:825 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-3003
Practice Address - Country:US
Practice Address - Phone:419-434-9232
Practice Address - Fax:888-375-3294
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-11
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.17082-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily