MEDICARE: GWEN HAU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN.350627	OH

General Provider Information

NPI Number	:	1063963460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GWEN HAU

Provider Business Mailing Address
First Line	:	6850 MEADOWOOD DR
Second Line	:
City	:	MEDINA
State	:	OH
Zip	:	44256-9447
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 CHESTER AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44114-4604
Country	:	US
Telephone Number	:	216-838-8006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2016
Last Update Date	:	10/20/2016

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Directions to “ GWEN HAU ” Practice Location

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