Individual
MADISON FENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18697 BAGLEY RD, CLEVELAND, OH 44130-3417
(440) 816-6051
Mailing address
18697 BAGLEY RD, CLEVELAND, OH 44130-3417
(440) 816-6051
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0033875
OH
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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