Individual provider · Type 1 NPI
Tabetha Staten, NP
Gerontology Nurse Practitioner · Green, OH
NPI number
1104342138
Active
Practice location
1700 Boettler Rd Ste 100
Green, OH 44685-7793
Fax (330) 896-0032
Mailing address
944 Cherry St E
Canal Fulton, OH 44614-8669
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | APRN.CNP.021511 (OH) |
Gerontology Nurse Practitioner: Definition to come...
3 other providers at this address
About NPI 1104342138
Tabetha Staten, NP's National Provider Identifier is 1104342138, issued on Aug 22, 2017. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Green, OH. The record was last updated on Jul 2, 2026.