Individual
NICOLE MARIE SANTIAGO SEVASTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-6547
Mailing address
5560 LANSBURY LN, LYNDHURST, OH 44124-3818
(330) 559-4289
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
12154
OH
Other
Enumeration date
01/30/2011
Last updated
12/06/2011
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