Provider Demographics
NPI:1174879878
Name:GINLEY, PATRICK JOSEPH IV (CRNA)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:GINLEY
Suffix:IV
Gender:M
Credentials:CRNA
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:38786 A T HILL PL
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-8835
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9614 OLD JOHNNYCAKE RIDGE RD
Practice Address - Street 2:
Practice Address - City:CONCORD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44060-6521
Practice Address - Country:US
Practice Address - Phone:440-205-1225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CRNA.13467367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1174879878Medicaid