MEDICARE: MICHELLE CLAPHAM NP-C

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	363L00000X	Nurse Practitioner	COA05512-NP	OH

General Provider Information

NPI Number	:	1467560755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE CLAPHAM NP-C

Provider Business Mailing Address
First Line	:	10701 EAST BLVD # 111BW
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1702
Country	:	US
Telephone Number	:	216-791-3800
Fax Number	:	216-421-3066

Provider Business Practice Location Address
First Line	:	405 TALLMADGE RD # 120
Second Line	:
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44221-3342
Country	:	US
Telephone Number	:	330-920-8309
Fax Number	:	330-920-8317

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

Provider Enumeration Date	:	08/27/2006
Last Update Date	:	12/29/2015

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