Individual
JENNIFER LYNN BASALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, AGNP-C
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-4239
(216) 444-2200
Mailing address
3418 PRISCILLA AVE, PARMA, OH 44134-4239
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.0035303
OH
Other
Enumeration date
08/20/2024
Last updated
01/09/2025
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