Healthcare Provider Details

I. General information

NPI: 1780737825
Provider Name (Legal Business Name): PATRICIA LYNN KIEFER RNBSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD
CLEVELAND OH
44106-1702
US

IV. Provider business mailing address

PO BOX 436 6270 APPLE CREEK RD.
SMITHVILLE OH
44677-0436
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-3800
  • Fax:
Mailing address:
  • Phone: 330-464-3513
  • Fax: 330-669-3617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number312165
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: