Individual
WANCHANA ROSE NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 636-2340
(216) 445-1007
Mailing address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 636-2340
(216) 445-1007
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN.CNP.019591
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN.CNP.019591
APRN.CNP LICENSE
OH
Enumeration date
07/22/2016
Last updated
02/27/2026
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