Individual
JAMIE R ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
20800 CENTER RIDGE RD, STE 101, ROCKY RIVER, OH 44116-4312
(440) 331-8744
Mailing address
27025 OAKWOOD CIR, APT 128, OLMSTED FALLS, OH 44138-3619
(440) 225-4711
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
17610-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0163000
—
OH
Enumeration date
11/06/2015
Last updated
03/28/2017
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