MEDICARE: DONNA M KUTA 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
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.007228	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000512374	OTHER	OH	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952354391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA M KUTA CNP

Provider Business Mailing Address
First Line	:	6005 SOM CENTER RD
Second Line	:
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094-9646
Country	:	US
Telephone Number	:	440-946-7252
Fax Number	:

Provider Business Practice Location Address
First Line	:	3737 PARK EAST DR STE 220
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4347
Country	:	US
Telephone Number	:	440-368-6868
Fax Number	:	440-639-0393

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	05/13/2025

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