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General NPI Number Information
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NPI Number | 1215408836
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Entity Type | Individual
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Provider Name | DEVIN ROBERT OCKERMAN CRNA
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Gender | Male
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Dates
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Enumeration Date | 12/07/2018
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Last Update Date | 02/20/2019
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Provider Practice Location Address
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Address Line | 11100 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone | 216-844-3722
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Fax |
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Provider Business Mailing Address
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Address Line | 17461 LAKESEDGE TRL
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City | CHAGRIN FALLS
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State | OH
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Zip | 44023-2118
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Country | US
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Telephone | 440-279-3632
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 365443
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN.CRNA.019848
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License Number State | OH
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