Healthcare Provider Details

I. General information

NPI: 1811926355
Provider Name (Legal Business Name): JENNIFER L HEHR PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE # U10
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE # U10
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-9969
  • Fax: 216-445-7013
Mailing address:
  • Phone: 216-444-9969
  • Fax: 216-445-7013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50002362
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: