Healthcare Provider Details

I. General information

NPI: 1043306368
Provider Name (Legal Business Name): MARIA ELISA JAVIER OBIAS RN, MSN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA ELISA ANDRES JAVIER RN, BSN

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 02/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 EUCLID AVE
CLEVELAND OH
44103
US

IV. Provider business mailing address

4500 EUCLID AVE
CLEVELAND OH
44103
US

V. Phone/Fax

Practice location:
  • Phone: 216-432-7200
  • Fax: 216-432-7253
Mailing address:
  • Phone: 216-432-7200
  • Fax: 216-432-7253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberRN104309
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN104309
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN104309
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: