Healthcare Provider Details

I. General information

NPI: 1487820767
Provider Name (Legal Business Name): MEREDITH LAHL PPCNP-BC, PCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 11/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE # HSB-111
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-704-6719
  • Fax: 216-636-2190
Mailing address:
  • Phone: 216-704-6719
  • Fax: 216-636-2190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN305595
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberCOA.07873-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: