Individual
EILEEN A KING
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
363LP0200X
Pediatric Nurse Practitioner
Primary
3622-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221195
UNISON
OH
01
—
000000373982
ANTHEM
OH
01
—
000000526072
ANTHEM
OH
01
—
1020879170001
PA MEDICAID
PA
05
—
2348525
—
OH
01
—
363705
WELLCARE
OH
01
—
7195742
AETNA
OH
01
—
745928
BUCKEYE
OH
Enumeration date
07/26/2006
Last updated
07/06/2011
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