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NPI Code Detail

MEDICARE: GLORIA HARRIS-ISOM CRNA

MEDICARE:   GLORIA  HARRIS-ISOM  CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistRN173726OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003916305
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLORIA HARRIS-ISOM CRNA
Provider Business Mailing Address
First Line : 6355 PEARL RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44130-3000
Country : US
Telephone Number : 440-886-1010
Fax Number :
Provider Business Practice Location Address
First Line : 6355 PEARL RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44130-3000
Country : US
Telephone Number : 440-886-1010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 02/03/2020

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Directions to “ GLORIA HARRIS-ISOM CRNA” Practice Location

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