MEDICARE: MRS. CANDICE M RINELLA

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	376K00000X	Nurse's Aide

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2393646	OTHER	OH	STATE OF OHIO

General Provider Information

NPI Number	:	1689703449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CANDICE M RINELLA

Provider Business Mailing Address
First Line	:	6015 MONICA LN
Second Line	:
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-5105
Country	:	US
Telephone Number	:	216-518-1457
Fax Number	:

Provider Business Practice Location Address
First Line	:	6015 MONICA LN
Second Line	:
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-5105
Country	:	US
Telephone Number	:	216-518-1457
Fax Number	:

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	07/08/2007

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