# NURSE PRACTITIONER HEALTH SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Provider Health Group LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104181338
- **Authorized official:** RACHEL PETRICK (OWNER)
- **Authorized official phone:** (440) 879-1108

## Contact information

- **Practice address:** 15400 PEARL RD STE 238, STRONGSVILLE, OH 44136-6000
- **Practice address phone:** (440) 879-1108
- **Practice address fax:** (440) 334-5403
- **Mailing address:** 15400 PEARL RD STE 238, STRONGSVILLE, OH 44136-6000
- **Mailing address phone:** (440) 879-1108
- **Mailing address fax:** (440) 334-5403

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | COA.10757-NP | OH | Yes |

## Other

- **Enumeration date:** 07/13/2012
- **Last updated:** 03/19/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0068112 | — | OH |