Provider Demographics
NPI:1053914887
Name:KRABILL, MARY R
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:R
Last Name:KRABILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 STURBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-8790
Mailing Address - Country:US
Mailing Address - Phone:330-209-4582
Mailing Address - Fax:330-875-0434
Practice Address - Street 1:1712 STURBRIDGE DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:OH
Practice Address - Zip Code:44641-8790
Practice Address - Country:US
Practice Address - Phone:330-209-4582
Practice Address - Fax:330-875-0434
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2854193372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion