Individual
KATHLEEN T MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7700
(216) 286-6341
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP-019941
OH
364SP0200X
Pediatric Clinical Nurse Specialist
3152-NS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224402
UNISON
OH
01
—
000000372630
ANTHEM
OH
01
—
000000526142
ANTHEM
OH
05
—
1018896160001
—
PA
05
—
2582192
—
OH
01
—
363818
WELLCARE
OH
01
—
750908
BUCKEYE
OH
01
—
7768662
AETNA
OH
Enumeration date
07/16/2006
Last updated
12/07/2017
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