Healthcare Provider Details

I. General information

NPI: 1811016769
Provider Name (Legal Business Name): MIRNA I CARIAS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MIRNA I CORRIGAN-CARIAS

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 02/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD
CLEVELAND OH
44106-1702
US

IV. Provider business mailing address

10701 EAST BLVD
CLEVELAND OH
44106-1702
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-3800
  • Fax: 216-229-2891
Mailing address:
  • Phone: 216-791-3800
  • Fax: 216-229-2891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number241402
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number241402
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: