MEDICARE: NESREEN GHAZI JAWHARI PNP-PC

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	363LP0200X	Pediatric Nurse Practitioner	CNP.025120	OH

General Provider Information

NPI Number	:	1124662960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NESREEN GHAZI JAWHARI PNP-PC

Provider Business Mailing Address
First Line	:	7918 PINEGROVE AVE
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44129-2102
Country	:	US
Telephone Number	:	440-334-3901
Fax Number	:

Provider Business Practice Location Address
First Line	:	14701 DETROIT AVE STE 250
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-4109
Country	:	US
Telephone Number	:	216-221-5901
Fax Number	:

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

Provider Enumeration Date	:	11/05/2019
Last Update Date	:	01/16/2025

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