MEDICARE: MS. CYNTHIA LOU RODGERS MISCH R.N.

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	RN183990	OH

General Provider Information

NPI Number	:	1821288473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA LOU RODGERS MISCH R.N.

Provider Business Mailing Address
First Line	:	519 LAKE ERIE ST
Second Line	:
City	:	CONNEAUT
State	:	OH
Zip	:	44030-1362
Country	:	US
Telephone Number	:	440-599-6611
Fax Number	:

Provider Business Practice Location Address
First Line	:	519 LAKE ERIE ST
Second Line	:
City	:	CONNEAUT
State	:	OH
Zip	:	44030-1362
Country	:	US
Telephone Number	:	440-599-6611
Fax Number	:

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

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	07/30/2007

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