Provider Demographics
NPI:1780090605
Name:FYOCK, MARIA LOUISE (APRN)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:LOUISE
Last Name:FYOCK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 GRAHAM RD.
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2259
Mailing Address - Country:US
Mailing Address - Phone:330-926-9409
Mailing Address - Fax:330-926-9428
Practice Address - Street 1:275 GRAHAM RD.
Practice Address - Street 2:SUITE 4
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2259
Practice Address - Country:US
Practice Address - Phone:330-926-9409
Practice Address - Fax:330-926-9428
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.16110-NP363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology