Provider Demographics
NPI:1174705057
Name:PILLIOD-CARPENTER, KATHRYN A (FNP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:PILLIOD-CARPENTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 GLENDALE AVENUE 3RD FL
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614
Mailing Address - Country:US
Mailing Address - Phone:419-383-7100
Mailing Address - Fax:419-383-2000
Practice Address - Street 1:2702 NAVARRE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3223
Practice Address - Country:US
Practice Address - Phone:419-698-8560
Practice Address - Fax:419-698-8570
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09779NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily