Healthcare Provider Details

I. General information

NPI: 1437835915
Provider Name (Legal Business Name): JEAN E POLSTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 06/28/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 EUCLID AVE
CLEVELAND OH
44103-3736
US

IV. Provider business mailing address

2668 EDGEHILL RD
CLEVELAND HEIGHTS OH
44106-2806
US

V. Phone/Fax

Practice location:
  • Phone: 216-409-1423
  • Fax:
Mailing address:
  • Phone: 216-409-1423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number245276
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: