Healthcare Provider Details

I. General information

NPI: 1609612027
Provider Name (Legal Business Name): CNP EXPRESS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2024
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 WILLIAMS RESERVE BLVD
WADSWORTH OH
44281-9317
US

IV. Provider business mailing address

322 BROOKSHIRE OVAL
HINCKLEY OH
44233-9618
US

V. Phone/Fax

Practice location:
  • Phone: 330-410-3688
  • Fax:
Mailing address:
  • Phone: 330-410-3688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RHONDA KOCINSKI
Title or Position: OWNER/OPERATOR
Credential: NP
Phone: 330-410-3688