Healthcare Provider Details

I. General information

NPI: 1518951540
Provider Name (Legal Business Name): DANIEL M GAUNTNER CNS, CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12201 EUCLID AVE
CLEVELAND OH
44106-4310
US

IV. Provider business mailing address

12201 EUCLID AVE
CLEVELAND OH
44106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 216-721-4010
  • Fax:
Mailing address:
  • Phone: 216-721-4010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.10709-NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberCOA.06850-NS
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN260385
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: