Individual
MISS DIANNA LYNETTE BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1346 E 94TH ST, CLEVELAND, OH 44106-1010
(216) 325-8010
Mailing address
1346 E 94TH ST, CLEVELAND, OH 44106-1010
(216) 325-8010
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
139142
OH
Other
Enumeration date
07/08/2010
Last updated
07/10/2010
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