Individual
JACOB KEITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4400 EUCLID AVE, CLEVELAND, OH 44103-3734
(216) 432-7200
Mailing address
4500 EUCLID AVE, CLEVELAND, OH 44103-3736
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
416708
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
416708
RN
OH
Enumeration date
05/23/2017
Last updated
05/23/2017
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