Healthcare Provider Details

I. General information

NPI: 1700556669
Provider Name (Legal Business Name): JULIANA R EGAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIANA R KIVETT

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6780 MAYFIELD RD
MAYFIELD HEIGHTS OH
44124-2203
US

IV. Provider business mailing address

14363 PEARLVIEW DR
STRONGSVILLE OH
44136-5247
US

V. Phone/Fax

Practice location:
  • Phone: 440-312-4500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.0020351
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: