Organization
PRIMARY NURSE PRACTITIONER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE M PIRC NP (NURSE PRACTITIONER)
(440) 392-9550
Entity
Organization
Contact information
Practice address
5301 E HEISLEY RD, MENTOR, OH 44060
(440) 392-9550
(440) 392-9550
Mailing address
PO BOX 74736, CLEVELAND, OH 44194-4194
(216) 472-2730
(216) 472-2740
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP03495
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2964501
—
OH
01
—
DG4680
MEDICARE RAILROAD GROUP PIN NUMBER
OH
Enumeration date
09/25/2007
Last updated
05/13/2014
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