Healthcare Provider Details

I. General information

NPI: 1407377765
Provider Name (Legal Business Name): MEGAN LEE KUHLENSCHMIDT NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

101 GRANITE CT
BEREA OH
44017-1077
US

V. Phone/Fax

Practice location:
  • Phone: 216-286-3820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.021094
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: