Basic Information
| Provider Information | |||||||||
| NPI: | 1578019600 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAFFORD | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | KAREN | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 925 TRAILWOOD DR | ||||||||
| Address2: | |||||||||
| City: | YOUNGSTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 445125008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307587575 | ||||||||
| FaxNumber: | 3307581833 | ||||||||
| Practice Location | |||||||||
| Address1: | 150 CARTER CIR | ||||||||
| Address2: | |||||||||
| City: | YOUNGSTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 445126630 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306921697 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2016 | ||||||||
| LastUpdateDate: | 04/24/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 2016019138 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | RN334054 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.