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Individual

MS. CARLA S TATE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
28820 CHAGRIN BLVD, APT.216, WOODMERE, OH 44122-4641
(216) 772-7725
Mailing address
28820 CHAGRIN BLVD, APT 219, WOODMERE, OH 44122-4641
(216) 772-7725

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
340388
OH
347C00000X
Private Vehicle
RH042828
OH

Other

Enumeration date
06/05/2008
Last updated
02/02/2017
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