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General NPI Number Information
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NPI Number | 1912310160
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Entity Type | Individual
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Provider Name | KATHERINE WALLENSTEIN CNP
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Gender | Female
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Dates
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Enumeration Date | 06/05/2014
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 11100 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone | 216-844-1915
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 772928
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City | DETROIT
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State | MI
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Zip | 48277-2928
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Country | US
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Telephone | 800-589-6006
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 15804
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.15804
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License Number State | OH
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