Healthcare Provider Details

I. General information

NPI: 1508417288
Provider Name (Legal Business Name): FORREST FOLK FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2019
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7575 NORTHCLIFF AVE
BROOKLYN OH
44144-3267
US

IV. Provider business mailing address

7575 NORTHCLIFF AVE
BROOKLYN OH
44144-3267
US

V. Phone/Fax

Practice location:
  • Phone: 216-539-2702
  • Fax:
Mailing address:
  • Phone: 216-539-2702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.025814
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: