Healthcare Provider Details

I. General information

NPI: 1144762360
Provider Name (Legal Business Name): CUYAHOGA COMMUNITY COLLEGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2016
Last Update Date: 11/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26242 DENNISPORT DR
OAKWOOD VILLAGE OH
44146-5948
US

IV. Provider business mailing address

26242 DENNISPORT DR
OAKWOOD VILLAGE OH
44146-5948
US

V. Phone/Fax

Practice location:
  • Phone: 216-571-9943
  • Fax:
Mailing address:
  • Phone: 216-571-9943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MS. RHONDA A HOOKS
Title or Position: FAMILY NURSE PRACTITIONER
Credential: FNP
Phone: 216-571-9943