Healthcare Provider Details

I. General information

NPI: 1982008561
Provider Name (Legal Business Name): SARAH CATHERINE KUSEK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA C STALTER FNP

II. Dates (important events)

Enumeration Date: 10/10/2014
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 W 25TH ST STE 4A
CLEVELAND OH
44113-3108
US

IV. Provider business mailing address

15800 DETROIT AVE
LAKEWOOD OH
44107-3748
US

V. Phone/Fax

Practice location:
  • Phone: 216-363-2292
  • Fax: 216-425-7708
Mailing address:
  • Phone: 216-226-8700
  • Fax: 216-221-3171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number16666
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: