Healthcare Provider Details

I. General information

NPI: 1275398695
Provider Name (Legal Business Name): JOANNA TOMCANY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20611 EUCLID AVE
EUCLID OH
44117-1521
US

IV. Provider business mailing address

289 E OVERLOOK DR
EASTLAKE OH
44095-1110
US

V. Phone/Fax

Practice location:
  • Phone: 855-967-2436
  • Fax:
Mailing address:
  • Phone: 440-221-9827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number453432
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: