Healthcare Provider Details

I. General information

NPI: 1386994994
Provider Name (Legal Business Name): MAUREEN CLAIRE SWEENEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2012
Last Update Date: 02/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 EUCLID AVE
CLEVELAND OH
44103-3734
US

IV. Provider business mailing address

1744 PAYNE AVE
CLEVELAND OH
44114-2910
US

V. Phone/Fax

Practice location:
  • Phone: 216-431-5800
  • Fax:
Mailing address:
  • Phone: 216-623-6555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCOA13936NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number358483
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: