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NPI Code Detail

MEDICARE: MS. DEIDRE LYNN ARCH CNP

MEDICARE: MS. DEIDRE LYNN ARCH CNP
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
1363LA2200XAdult Health Nurse Practitioner025302OH

General Provider Information

NPI Number : 1881234193
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEIDRE LYNN ARCH CNP
Provider Business Mailing Address
First Line : 580 CHANCELLOR CIR
Second Line :
City : AVON LAKE
State : OH
Zip : 44012-2539
Country : US
Telephone Number : 440-653-5175
Fax Number :
Provider Business Practice Location Address
First Line : 6801 BRECKSVILLE RD STE 10
Second Line :
City : INDEPENDENCE
State : OH
Zip : 44131-5057
Country : US
Telephone Number : 216-444-4663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2020
Last Update Date : 01/14/2020

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