Organization
CLEVELAND CLINIC FOUNDATON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS AMANDA RENEE BONHAM CNP (NURSE PRACTITIONER)
(330) 990-1907
Entity
Organization
Contact information
Practice address
CLEVELAND CLINIC FOUNDATION, R35, CLEVELAND, OH 44195-0001
(330) 990-1907
Mailing address
1440 MAILE AVE, DOWN UNIT, LAKEWOOD, OH 44107-3315
(330) 990-1907
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
COA.17341-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
COA.17341-NP
OHIO BOARD OF NURSING
OH
01
—
RN.354139-1
OHIO BOARD OF NURSING
OH
Enumeration date
07/18/2015
Last updated
07/18/2015
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