Healthcare Provider Details

I. General information

NPI: 1124955471
Provider Name (Legal Business Name): CHRISTINA BREESE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

6217 STATE RD
WADSWORTH OH
44281-9787
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-3877
  • Fax:
Mailing address:
  • Phone: 330-606-1475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.382956
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: