Provider Demographics
NPI:1730565235
Name:OBERT, PAIGE E (AG-ACNP, BC)
Entity type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:E
Last Name:OBERT
Suffix:
Gender:F
Credentials:AG-ACNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 MERCY HEALTH BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-1109
Mailing Address - Country:US
Mailing Address - Phone:513-559-7025
Mailing Address - Fax:513-981-5755
Practice Address - Street 1:3301 MERCY HEALTH BLVD STE 300
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-1109
Practice Address - Country:US
Practice Address - Phone:513-559-7025
Practice Address - Fax:513-981-5755
Is Sole Proprietor?:No
Enumeration Date:2015-08-06
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.18286363LG0600X, 363LA2100X, 363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0147298Medicaid