Healthcare Provider Details

I. General information

NPI: 1295494409
Provider Name (Legal Business Name): SIERRA WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2021
Last Update Date: 12/15/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1895 FARMINGTON RD
CLEVELAND OH
44112-4743
US

IV. Provider business mailing address

1895 FARMINGTON RD
CLEVELAND OH
44112-4743
US

V. Phone/Fax

Practice location:
  • Phone: 216-785-0534
  • Fax:
Mailing address:
  • Phone: 216-785-0534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberA2Z6D6A8
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: