Individual
SANDRA JEAN WAHL-PIECUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
9000 MENTOR AVE STE 215, MENTOR, OH 44060-4498
(440) 205-5870
(440) 205-5881
Mailing address
24701 EUCLID AVE, THIRD FLOOR - BILLING SERVICES, EUCLID, OH 44117-1714
(440) 205-5870
(440) 205-5881
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN228416 NP08215
OH
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
08215-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2621587
—
OH
Enumeration date
03/24/2006
Last updated
07/09/2012
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