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Individual

JAIMIE N. BANOZIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
2500 E 22ND ST, CLEVELAND, OH 44115-3204
(216) 931-1407
(216) 931-1414
Mailing address
2500 E 22ND ST, CLEVELAND, OH 44115-3204
(216) 931-1407

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NP08108
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2544536
OH
Enumeration date
07/05/2006
Last updated
05/12/2008
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