Healthcare Provider Details

I. General information

NPI: 1669086955
Provider Name (Legal Business Name): COLLEEN A GEPPERTH CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD
CLEVELAND OH
44106-1702
US

IV. Provider business mailing address

8787 BROOKPARK RD
PARMA OH
44129-6809
US

V. Phone/Fax

Practice location:
  • Phone: 216-570-5362
  • Fax:
Mailing address:
  • Phone: 216-739-7000
  • Fax: 216-229-2597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN.CNP.0027230
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: