Healthcare Provider Details

I. General information

NPI: 1295368488
Provider Name (Legal Business Name): PRESTON ALEXANDER EPLING CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2020
Last Update Date: 02/17/2020
Certification Date: 02/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE # R3
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

1586 LACLEDE RD
SOUTH EUCLID OH
44121-3012
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-8356
  • Fax:
Mailing address:
  • Phone: 330-235-4522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberAPRN.CNP.026342
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.026342
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: