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General NPI Number Information
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NPI Number | 1770667958
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Entity Type | Individual
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Provider Name | KATHLEEN M ZUPAN CNP
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10701 EAST BLVD FIRM A
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City | CLEVELAND
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State | OH
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Zip | 44106-1702
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Country | US
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Telephone | 216-791-3800
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Fax | 216-707-5959
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Provider Business Mailing Address
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Address Line | 625 BRENNANS CT
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City | AVON LAKE
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State | OH
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Zip | 44012-4012
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Country | US
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Telephone | 216-791-3800
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Fax | 216-707-5959
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NP05285
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License Number State | OH
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