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General NPI Number Information
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NPI Number | 1093629859
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Entity Type | Individual
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Provider Name | MARIAH JORDAN BIG PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 223 MILLER RD
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City | AVON LAKE
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State | OH
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Zip | 44012-1004
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Country | US
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Telephone | 440-930-2002
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Fax |
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Provider Business Mailing Address
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Address Line | 43625 OBERLIN ELYRIA RD
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City | OBERLIN
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State | OH
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Zip | 44074-9767
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Country | US
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Telephone | 440-636-3331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0043489
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License Number State | OH
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