Healthcare Provider Details

I. General information

NPI: 1629953062
Provider Name (Legal Business Name): MICHELLE EISEMAN APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 W BOWERY ST
AKRON OH
44308-1046
US

IV. Provider business mailing address

214 W BOWERY ST
AKRON OH
44308-1046
US

V. Phone/Fax

Practice location:
  • Phone: 330-549-5015
  • Fax:
Mailing address:
  • Phone: 330-543-5015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number426028
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: