Individual
AMANDA AHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106
(216) 844-3771
Mailing address
3605 WARRENSVILLE CENTER ROAD, 1ST FLOOR, SHAKER, OH 44122
(216) 286-6260
(216) 286-6341
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN295486
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
RN295486
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0583328
BCMH
OH
05
—
2821254
—
OH
01
—
ANTHEM
000000558101
OH
01
—
P00471411
RAILROAD MEDICARE
OH
Enumeration date
12/03/2007
Last updated
07/30/2008
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