Individual
KRISTY HERZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-8442
Mailing address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-8442
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
COA.17000-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17000-NP
CERTIFICATE OF AUTHORITY
OH
01
—
344331
RN
OH
Enumeration date
02/24/2015
Last updated
01/14/2021
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