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General NPI Number Information
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NPI Number | 1760226070
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Entity Type | Individual
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Provider Name | AMELIA DUCKETT
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Gender | Female
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Dates
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Enumeration Date | 06/21/2024
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 18697 BAGLEY RD
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City | MIDDLEBURG HEIGHTS
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State | OH
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Zip | 44130-3417
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Country | US
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Telephone | 440-816-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1636 OAKMOUNT RD
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City | SOUTH EUCLID
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State | OH
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Zip | 44121-4006
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Country | US
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Telephone |
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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 | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | APRN.CNS.0019498
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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 | 416187
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License Number State | OH
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