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General NPI Number Information
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NPI Number | 1447635602
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Entity Type | Individual
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Provider Name | CATHRYN BAACK NP
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Gender | Female
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 1324 FORD RD
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City | LYNDHURST
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State | OH
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Zip | 44124-1431
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Country | US
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Telephone | 614-284-8476
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Fax | 216-755-5195
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Provider Business Mailing Address
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Address Line | 1324 FORD RD
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City | LYNDHURST
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State | OH
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Zip | 44124-1431
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Country | US
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Telephone | 614-284-8476
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Fax | 216-755-5195
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | COA 07452-NP
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN-204029-1
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License Number State | OH
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