Healthcare Provider Details

I. General information

NPI: 1992104392
Provider Name (Legal Business Name): JENNIFER MEECHA CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ZAWISTOWSKI

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 08/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18101 LORAIN AVE
CLEVELAND OH
44111-5612
US

IV. Provider business mailing address

PO BOX 74953
CLEVELAND OH
44194-1036
US

V. Phone/Fax

Practice location:
  • Phone: 216-476-7000
  • Fax: 440-879-0084
Mailing address:
  • Phone: 440-879-0081
  • Fax: 440-879-0084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberNS-15256
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: