=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326928920
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARA TOMBOW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/04/2025
-----------------------------------------------------
Last Update Date | 09/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3999 RICHMOND RD
-----------------------------------------------------
City | BEACHWOOD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44122-6046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-593-5500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10481 WHITE ASH TRL
-----------------------------------------------------
City | TWINSBURG
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44087-2659
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-840-7227
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | AG08250080
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------