Healthcare Provider Details

I. General information

NPI: 1497593248
Provider Name (Legal Business Name): AMBER RUMBAUGH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2024
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 W 25TH ST UNIT 1
CLEVELAND OH
44113-3184
US

IV. Provider business mailing address

2158 WOODLAND TRCE
AUSTINTOWN OH
44515-4826
US

V. Phone/Fax

Practice location:
  • Phone: 216-685-9975
  • Fax:
Mailing address:
  • Phone: 330-207-9002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0036425
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: