MEDICARE: EBONY PRICE

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0041007	OH
2	163W00000X	Registered Nurse	386170	OH

General Provider Information

NPI Number	:	1063845204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EBONY PRICE

Provider Business Mailing Address
First Line	:	7427 OTIS CT
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-3021
Country	:	US
Telephone Number	:	216-224-9862
Fax Number	:

Provider Business Practice Location Address
First Line	:	7427 OTIS CT
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-3021
Country	:	US
Telephone Number	:	216-224-9862
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2013
Last Update Date	:	12/20/2025

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Directions to “ EBONY PRICE ” Practice Location

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