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Organization
SENIOR NURSE PRACTITIONER SERVICES, LLC
Active
Organization
SENIOR NURSE PRACTITIONER SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH EZZIE C.N.P. (OWNER)
(216) 387-9896
Entity
Organization
Contact information
Practice address
703 CORNELL DR, BROADVIEW HEIGHTS, OH 44147-4412
(216) 387-9896
Mailing address
PO BOX 470531, BROADVIEW HEIGHTS, OH 44147-4412
(216) 387-9896
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
COA07369-NP
OH
363LG0600X
Gerontology Nurse Practitioner
Primary
COA07369-NP
OH
363LG0600X
Gerontology Nurse Practitioner
—
NULL
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Enumeration date
07/02/2009
Last updated
10/30/2020
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