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Individual

ROSEMARY G ETHEART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
28105 CLEMENS RD, BLDG 3, WESTLAKE, OH 44145-1100
(440) 788-4500
(440) 835-4376
Mailing address
26908 DETROIT RD, SUITE 301, WESTLAKE, OH 44145-2398
(440) 617-1823
(440) 617-0884

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN167684
OH
363L00000X
Nurse Practitioner
Primary
COA.03116-NP
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2577966
OH
Enumeration date
09/06/2005
Last updated
11/13/2020
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