Healthcare Provider Details

I. General information

NPI: 1437703584
Provider Name (Legal Business Name): CHRISTINA FUNDZAK CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2019
Last Update Date: 02/09/2025
Certification Date: 02/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

13841 MONICA DR
NORTH ROYALTON OH
44133-4111
US

V. Phone/Fax

Practice location:
  • Phone: 440-703-8856
  • Fax:
Mailing address:
  • Phone: 440-623-4692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number027741
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number024741
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: