Healthcare Provider Details

I. General information

NPI: 1609412709
Provider Name (Legal Business Name): HOWARD WETZLER CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2019
Last Update Date: 05/08/2020
Certification Date: 05/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-9024
US

IV. Provider business mailing address

67783 OLD TWENTY ONE RD
CAMBRIDGE OH
43725-9024
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-0181
  • Fax: 216-445-5650
Mailing address:
  • Phone: 740-260-6993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number388723
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.026682
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: