Individual
JAN L. MAXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3941
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
RN 173677
OH
363LA2100X
Acute Care Nurse Practitioner
COA.07928-NP
OH
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
COA.07928-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221148
UNISON
OH
01
—
000000509176
ANTHEM
OH
05
—
2502492
—
OH
05
—
2833401
—
OH
01
—
363817
WELLCARE
OH
01
—
7245609
AETNA
OH
01
—
750907
BUCKEYE
OH
01
—
P00908727
RAILROAD MEDICARE
OH
Enumeration date
07/13/2006
Last updated
10/14/2013
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