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NPI Code Detail

MEDICARE: LYNDSEY RACHELLE DECESARE

MEDICARE: LYNDSEY RACHELLE DECESARE
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
1363L00000XNurse PractitionerAPRN.CNP.025741OH

General Provider Information

NPI Number : 1912540543
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNDSEY RACHELLE DECESARE
Provider Business Mailing Address
First Line : PO BOX 952041
Second Line :
City : CLEVELAND
State : OH
Zip : 44192-0051
Country : US
Telephone Number : 855-449-1540
Fax Number : 440-672-5068
Provider Business Practice Location Address
First Line : 6559 WILSON MILLS RD STE 106A
Second Line :
City : MAYFIELD VILLAGE
State : OH
Zip : 44143-3433
Country : US
Telephone Number : 855-449-1540
Fax Number : 440-672-5068
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2019
Last Update Date : 05/14/2024

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Directions to “ LYNDSEY RACHELLE DECESARE ” Practice Location

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