Healthcare Provider Details

I. General information

NPI: 1447176482
Provider Name (Legal Business Name): WARDA JAFFAL CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 OBERLIN AVE
LORAIN OH
44053-2752
US

IV. Provider business mailing address

6476 SURREY DR
NORTH OLMSTED OH
44070-4862
US

V. Phone/Fax

Practice location:
  • Phone: 440-282-9189
  • Fax: 440-960-0002
Mailing address:
  • Phone: 440-655-3008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0038302
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: