Individual
JENNA BURCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18697 BAGLEY RD, MIDDLEBURG HEIGHTS, OH 44130-3417
(440) 542-5000
Mailing address
30680 BAINBRIDGE RD, CLEVELAND, OH 44139-2282
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
16576-NP
OH
390200000X
Student in an Organized Health Care Education/Training Program
RN338759
OH
Other
Enumeration date
06/10/2014
Last updated
12/30/2014
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