Healthcare Provider Details

I. General information

NPI: 1629740675
Provider Name (Legal Business Name): RACHAEL ALEXIS JIVIDEN MSN, APRN, ACCNS-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 09/29/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

CLEVELAND CLINIC 9500 EUCLID AVENUE
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-389-3716
  • Fax:
Mailing address:
  • Phone: 216-389-3716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberAPRN.CNS.0019450
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: