Individual
JESSICA MARIE DER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, NP-C
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-2200
Mailing address
1290 DONALD AVE, LAKEWOOD, OH 44107-2852
(423) 316-9163
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN.359901
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.022772
OH
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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