Healthcare Provider Details

I. General information

NPI: 1376384297
Provider Name (Legal Business Name): JOEL HUKILL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18697 BAGLEY RD
MIDDLEBURG HEIGHTS OH
44130-3417
US

IV. Provider business mailing address

30575 BAINBRIDGE RD STE 200
SOLON OH
44139-2275
US

V. Phone/Fax

Practice location:
  • Phone: 440-816-8000
  • Fax:
Mailing address:
  • Phone: 440-542-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0036596
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: