Individual
STEPHANIE A KLISAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 286-7015
(216) 286-7015
Mailing address
3549 BIRDLAND AVE, AKRON, OH 44319-2223
(330) 620-0523
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN.348005
OH
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
APRN.CNP.021582
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN.CNP.021582
LICENSE NUMBER
OH
01
—
RN.348005
RN LICENSE NUMBER
OH
Enumeration date
08/24/2017
Last updated
08/24/2017
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