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General NPI Number Information
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NPI Number | 1336876259
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Entity Type | Individual
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Provider Name | MOLLY KAY MACEJKO NP
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Gender | Female
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Dates
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Enumeration Date | 08/02/2022
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Last Update Date | 10/14/2022
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44195-0002
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Country | US
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Telephone | 216-444-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 3924 W 158TH ST
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City | CLEVELAND
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State | OH
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Zip | 44111-4271
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Country | US
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Telephone | 330-402-1287
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN.CNP.0032395
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN368265
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License Number State | OH
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