DRUCILLA BACON CRNP NPI 1912270620

NPI Information

NPI: 1912270620
Provider Name: DRUCILLA BACON, CRNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
33 NORTH AVE
#104
TALLMADGE, OH
ZIP 44278
Phone: (330) 344-3990
Get Directions

Drucilla Bacon, CRNP is a family nurse practitioner in Tallmadge, OH. Drucilla Bacon, CRNP NPI is 1912270620. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

33 NORTH AVE
#104
TALLMADGE, OH
ZIP 44278-925
Phone: (330) 344-3990
Fax: (330) 634-9433

The enumeration date for this NPI number is 2/13/2012 and was last updated on 3/17/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	NP-13312	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0091231	OTHER	OHIO	PARTNERS PHYSICIAN GROUP MEDICAID GROUP # URGENT CARE
2	0066886	MEDICAID	OHIO
3	1841239274	OTHER	OHIO	PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
4	2551671	OTHER	OHIO	PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
5	H010534	MEDICARE PIN	OHIO
6	1992138028	OTHER	OHIO	PARTNERS PHYSICIAN GROUP TYPE 2 NPI # URGENT CARE
7	9338635	OTHER	OHIO	PARTNERS PHYSICIAN GROUP MEDICARE GROUP #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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