Healthcare Provider Details

I. General information

NPI: 1467769935
Provider Name (Legal Business Name): MICHELE A IERACI APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2010
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 TRAILWOOD DR
YOUNGSTOWN OH
44512-5008
US

IV. Provider business mailing address

8006 GRAYSON DR
CANFIELD OH
44406-7614
US

V. Phone/Fax

Practice location:
  • Phone: 330-758-7575
  • Fax:
Mailing address:
  • Phone: 330-533-1673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.11620
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: