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General NPI Number Information
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NPI Number | 1831060227
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Entity Type | Individual
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Provider Name | DENISA IVAN CAA
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Gender | Female
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 5005 PARKCENTER AVE
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City | DUBLIN
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State | OH
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Zip | 43017-3582
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Country | US
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Telephone | 614-932-9548
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Fax |
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Provider Business Mailing Address
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Address Line | 32624 GREENWOOD DR
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City | AVON LAKE
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State | OH
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Zip | 44012-1626
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Country | US
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Telephone | 440-787-7772
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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 | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | 67.000575
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License Number State | OH
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