Healthcare Provider Details

I. General information

NPI: 1003104837
Provider Name (Legal Business Name): LAURA RHODES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2011
Last Update Date: 01/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVENUE
CLEVELAND OH
44195
US

IV. Provider business mailing address

9500 EUCLID AVENUE
CLEVELAND OH
44195
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-8878
  • Fax:
Mailing address:
  • Phone: 216-445-8878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number28160841A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number0001224227
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN1018593
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberR191525
License Number StateMD
# 5
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number13009-NP
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number13009
License Number StateOH
# 7
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number374043
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: