MEDICARE: MRS. TERESA RUDD GAETA MSN,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
1	363LA2200X	Adult Health Nurse Practitioner	RN155522 NP01623	OH

General Provider Information

NPI Number	:	1881677045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERESA RUDD GAETA MSN,CNP

Provider Business Mailing Address
First Line	:	38646 BELL RD
Second Line	:
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094-7522
Country	:	US
Telephone Number	:	440-269-1527
Fax Number	:

Provider Business Practice Location Address
First Line	:	29400 LAKELAND BLVD
Second Line	:	LUBRIZOL CORPORATION MEDICAL DEPAR
City	:	WICKLIFFE
State	:	OH
Zip	:	44092
Country	:	US
Telephone Number	:	440-347-2411
Fax Number	:	440-347-4704

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	09/26/2007

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