Individual
ANDREA DURHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
10307 ROSEHILL AVE, CLEVELAND, OH 44104-3640
(216) 820-7686
Mailing address
10307 ROSEHILL AVE, CLEVELAND, OH 44104-3640
(216) 820-7686
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN152598
OH
Other
Enumeration date
12/13/2013
Last updated
12/13/2013
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