Healthcare Provider Details

I. General information

NPI: 1497724363
Provider Name (Legal Business Name): NADIA ANN KOBAL CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NADIA ANN KOBAL CPNP

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

375 TIMBERIDGE TRL
GATES MILLS OH
44040-9319
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-8641
  • Fax:
Mailing address:
  • Phone: 440-477-1489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberCOA.08295-NP
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN.08295
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: