Provider Demographics
NPI:1174948483
Name:WOLINSKI, MARY JO
Entity type:Individual
Prefix:
First Name:MARY JO
Middle Name:
Last Name:WOLINSKI
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 1:948 HAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-1952
Mailing Address - Country:US
Mailing Address - Phone:330-467-8544
Mailing Address - Fax:
Practice Address - Street 1:8819 COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-4101
Practice Address - Country:US
Practice Address - Phone:330-425-2212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN256725163W00000X
OHCOA.15851-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse