Healthcare Provider Details

I. General information

NPI: 1902686710
Provider Name (Legal Business Name): KATHERINE ELISE BARTOLOTTA MSN, APRN, CPNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 10/02/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18101 LORAIN AVE
CLEVELAND OH
44111-5612
US

IV. Provider business mailing address

288 GAYLORD DR
MUNROE FALLS OH
44262-1250
US

V. Phone/Fax

Practice location:
  • Phone: 216-476-7000
  • Fax:
Mailing address:
  • Phone: 330-416-8882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN.CNP.0034782
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.4182274
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: