Healthcare Provider Details

I. General information

NPI: 1295303410
Provider Name (Legal Business Name): MARY JO NAIDA MSN, ACCNS-AG, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2021
Last Update Date: 06/14/2021
Certification Date: 06/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-403-9748
  • Fax:
Mailing address:
  • Phone: 216-444-1678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberAPRN.CNS.019426
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: