Healthcare Provider Details

I. General information

NPI: 1285067355
Provider Name (Legal Business Name): PRAVEENA PRASAI BERLIN APRN.CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PRAVEENA PRASAI SHARMA APRN.CNP

II. Dates (important events)

Enumeration Date: 08/13/2013
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25700 SCIENCE PARK DR STE 210
BEACHWOOD OH
44122-7328
US

IV. Provider business mailing address

PO BOX 844020
DALLAS TX
75284-4020
US

V. Phone/Fax

Practice location:
  • Phone: 216-450-1613
  • Fax:
Mailing address:
  • Phone: 216-450-1613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.16991
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3008238
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.16991
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: