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General NPI Number Information
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NPI Number | 1588102586
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Entity Type | Individual
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Provider Name | JESSICA A MCMULLEN CRNA
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Gender | Female
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 11/06/2018
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Provider Practice Location Address
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Address Line | CLEVELAND CLINIC 9500 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-798-2659
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Fax |
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Provider Business Mailing Address
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Address Line | 6300 GREENWOOD PKWY 406
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City | SAGAMORE HILLS
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State | OH
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Zip | 44067-2393
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Country | US
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Telephone | 216-798-2659
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 112855
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License Number State | OH
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