Healthcare Provider Details

I. General information

NPI: 1730421322
Provider Name (Legal Business Name): JULIA ALLEGRA BISSETT MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIA ALLEGRA VERES MSN, APRN, PMHNP-BC

II. Dates (important events)

Enumeration Date: 03/21/2013
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5350 TRANSPORTATION BLVD STE 22
GARFIELD HEIGHTS OH
44125-5307
US

IV. Provider business mailing address

5350 TRANSPORTATION BLVD STE 22
GARFIELD HEIGHTS OH
44125-5307
US

V. Phone/Fax

Practice location:
  • Phone: 216-435-1110
  • Fax: 216-472-8996
Mailing address:
  • Phone: 216-435-1110
  • Fax: 216-472-8996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCOA.15807-NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN.372209
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: