Healthcare Provider Details

I. General information

NPI: 1003129065
Provider Name (Legal Business Name): JENNIFER LYNN PARRY RN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER LYNN DILUCIANO

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 10/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

5601 ABBYSHIRE DR
HUDSON OH
44236-2683
US

V. Phone/Fax

Practice location:
  • Phone: 216-983-5691
  • Fax:
Mailing address:
  • Phone: 216-272-4335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberCOA.11606-NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN277332-COA1
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: