Healthcare Provider Details

I. General information

NPI: 1467678565
Provider Name (Legal Business Name): MS. CLAUDEINE HARDAWAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1795 W 25TH ST SUITE 1041
CLEVELAND OH
44113-3112
US

IV. Provider business mailing address

1795 W 25TH ST SUITE 1041
CLEVELAND OH
44113-3112
US

V. Phone/Fax

Practice location:
  • Phone: 216-621-4356
  • Fax: 216-621-4356
Mailing address:
  • Phone: 216-621-4356
  • Fax: 216-621-4356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number375604560596
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: