Healthcare Provider Details

I. General information

NPI: 1750295143
Provider Name (Legal Business Name): DEVON ETLING R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8979 MENTOR AVE
MENTOR OH
44060-6326
US

IV. Provider business mailing address

8979 MENTOR AVE
MENTOR OH
44060-6326
US

V. Phone/Fax

Practice location:
  • Phone: 440-974-2264
  • Fax: 440-974-2259
Mailing address:
  • Phone: 440-974-2264
  • Fax: 440-974-2259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.537166
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: