MEDICARE: JENNIFER GAWELEK R.N.

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	163W00000X	Registered Nurse	RN363086	OH

General Provider Information

NPI Number	:	1770836454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER GAWELEK R.N.

Provider Business Mailing Address
First Line	:	4777 LANDCHESTER RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-5601
Country	:	US
Telephone Number	:	440-260-8379
Fax Number	:

Provider Business Practice Location Address
First Line	:	4777 LANDCHESTER RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-5601
Country	:	US
Telephone Number	:	440-260-8379
Fax Number	:	440-260-8214

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

Provider Enumeration Date	:	10/18/2012
Last Update Date	:	10/18/2012

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