Healthcare Provider Details

I. General information

NPI: 1467543801
Provider Name (Legal Business Name): LYNN MARIE BARABACH MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LYNN MARIE MUDRA MSN, RN

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

5742 PINNACLE PARK DR
SEVEN HILLS OH
44131-1758
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-1035
  • Fax: 216-844-5641
Mailing address:
  • Phone: 216-513-9450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License NumberRN.203233-COA1
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: