MEDICARE: LINDA SUSAN CICERCHI APRNBC

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	363LA2200X	Adult Health Nurse Practitioner	COA-NS-08469 RN31810	OH

General Provider Information

NPI Number	:	1730116963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA SUSAN CICERCHI APRNBC

Provider Business Mailing Address
First Line	:	99 NORTHLINE CIR
Second Line	:	SUITE 211
City	:	EUCLID
State	:	OH
Zip	:	44119
Country	:	US
Telephone Number	:	216-692-8803
Fax Number	:

Provider Business Practice Location Address
First Line	:	99 NORTHLINE CIR
Second Line	:	SUITE 211
City	:	EUCLID
State	:	OH
Zip	:	44119-1482
Country	:	US
Telephone Number	:	216-692-8803
Fax Number	:

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

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	07/08/2007

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