Healthcare Provider Details

I. General information

NPI: 1932107091
Provider Name (Legal Business Name): MICHELLE ANN CRAMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE ANN FRENCH

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 07/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36060 EUCLID AVE STE 107
WILLOUGHBY OH
44094-4661
US

IV. Provider business mailing address

36060 EUCLID AVE STE 107
WILLOUGHBY OH
44094-4661
US

V. Phone/Fax

Practice location:
  • Phone: 440-269-8346
  • Fax:
Mailing address:
  • Phone: 440-269-8346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number960559
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number10686-NP
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA10686-NP
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10686-NP
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberCOA10686-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: