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Individual

SHANA KIESWETTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1508 W RIVER RD N, ELYRIA, OH 44035-2714
(440) 647-8100
(440) 426-8375
Mailing address
4200 LEAVITT RD, LORAIN, OH 44053-2343

Taxonomy

Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
RN.542140
OH
164W00000X
Licensed Practical Nurse
LPN.179620.MEDS-IV
OH

Other

Enumeration date
12/09/2021
Last updated
07/19/2025
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