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NPI Code Detail

MEDICARE: MRS. KATHLEEN MARY PFAHL APRN BC CS

MEDICARE: MRS. KATHLEEN MARY PFAHL APRN BC CS
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
1163WW0000XWound Care Registered NurseRN12250OH
2163WX1500XOstomy Care Registered NurseRN122250OH
3364SM0705XMedical-Surgical Clinical Nurse SpecialistNS-06874OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN 122250OTHEROHSTATE BOARD OF NURSING
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3RX 06874OTHEROHSTATE BOARD OF NURSING

General Provider Information

NPI Number : 1891709887
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHLEEN MARY PFAHL APRN BC CS
Provider Business Mailing Address
First Line : 311 E 270TH ST
Second Line :
City : EUCLID
State : OH
Zip : 44132-1603
Country : US
Telephone Number : 216-798-5848
Fax Number : 216-383-3750
Provider Business Practice Location Address
First Line : 300 E 185TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44119-1330
Country : US
Telephone Number : 216-383-2222
Fax Number : 216-383-3750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 09/11/2025

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