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NPI Code Detail

MEDICARE: M ANASTASIA DRISCOLL CNP

MEDICARE: M ANASTASIA DRISCOLL CNP
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
1363L00000XNurse PractitionerNP08775OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760407027
Entity Type Code : Individual
Provider Name (Legal Business Name) : M ANASTASIA DRISCOLL CNP
Provider Business Mailing Address
First Line : 3518 W 25TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-1951
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3518 W 25TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-1951
Country : US
Telephone Number : 216-741-2244
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 11/16/2022

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