Provider Demographics
NPI:1164840765
Name:SOERGEL, PAULA ELIZABETH (CNP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:ELIZABETH
Last Name:SOERGEL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:ELIZABETH
Other - Last Name:SOERGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNP
Mailing Address - Street 1:1044 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1006
Mailing Address - Country:US
Mailing Address - Phone:330-480-3258
Mailing Address - Fax:330-480-4119
Practice Address - Street 1:1044 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1006
Practice Address - Country:US
Practice Address - Phone:330-480-3258
Practice Address - Fax:330-480-4119
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028797363LA2100X
VA0024175890363LA2100X
IAL134917363LA2100X, 363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine