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Individual
MRS. IVY CLEVELAND
Active
Individual
MRS. IVY CLEVELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN174879
GA
163W00000X
Registered Nurse
RN555465
PA
363LA2100X
Acute Care Nurse Practitioner
174879
GA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN174879
GA
363LG0600X
Gerontology Nurse Practitioner
174879
GA
Other
Enumeration date
01/30/2009
Last updated
09/01/2020
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