Healthcare Provider Details

I. General information

NPI: 1275713091
Provider Name (Legal Business Name): JEANIENE MARIE KALMAN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. JEANIENE MARIE MARIN

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4041 NORTHFIELD RD
WARRENSVILLE HEIGHTS OH
44122-7001
US

IV. Provider business mailing address

4041 NORTHFIELD RD
WARRENSVILLE HEIGHTS OH
44122-7001
US

V. Phone/Fax

Practice location:
  • Phone: 216-464-9100
  • Fax: 216-420-7870
Mailing address:
  • Phone: 216-464-9100
  • Fax: 216-420-7870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number07226
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number280671
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: