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NPI Code Detail

MEDICARE: JONATHAN P RUEDISUELI APRN, MSN, FNP-BC

MEDICARE: JONATHAN P RUEDISUELI APRN, MSN, FNP-BC
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
1163W00000XRegistered NurseRN.327840OH
2163W00000XRegistered Nurse1162168KY
3363LF0000XFamily Nurse Practitioner3013282KY
4363LF0000XFamily Nurse PractitionerAPRN.CNP.13528OH

General Provider Information

NPI Number : 1164784351
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN P RUEDISUELI APRN, MSN, FNP-BC
Provider Business Mailing Address
First Line : PO BOX 932958
Second Line :
City : CLEVELAND
State : OH
Zip : 44193-0028
Country : US
Telephone Number : 615-425-4200
Fax Number : 615-425-4268
Provider Business Practice Location Address
First Line : 5830 HARRISON AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-1623
Country : US
Telephone Number : 513-693-4035
Fax Number : 513-693-4036
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2012
Last Update Date : 04/02/2025

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