Healthcare Provider Details

I. General information

NPI: 1952354391
Provider Name (Legal Business Name): DONNA M KUTA CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 PARK EAST DR STE 220
BEACHWOOD OH
44122-4347
US

IV. Provider business mailing address

6005 SOM CENTER RD
WILLOUGHBY OH
44094-9646
US

V. Phone/Fax

Practice location:
  • Phone: 440-368-6868
  • Fax: 440-639-0393
Mailing address:
  • Phone: 440-946-7252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.007228
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: