Healthcare Provider Details

I. General information

NPI: 1760138291
Provider Name (Legal Business Name): CHRISTINE MICHELLE WARES CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2022
Last Update Date: 02/23/2022
Certification Date: 02/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

375 KENILWORTH RD
BAY VILLAGE OH
44140-2469
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-2200
  • Fax:
Mailing address:
  • Phone: 440-371-2309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberAPRN.CNM.0019506
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: