Provider Demographics
NPI:1043306368
Name:OBIAS, MARIA ELISA JAVIER (RN, MSN, CNS)
Entity Type:Individual
Prefix:MRS
First Name:MARIA ELISA
Middle Name:JAVIER
Last Name:OBIAS
Suffix:
Gender:F
Credentials:RN, MSN, CNS
Other - Prefix:MISS
Other - First Name:MARIA ELISA
Other - Middle Name:ANDRES
Other - Last Name:JAVIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:4500 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103
Mailing Address - Country:US
Mailing Address - Phone:216-432-7200
Mailing Address - Fax:216-432-7253
Practice Address - Street 1:4500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103
Practice Address - Country:US
Practice Address - Phone:216-432-7200
Practice Address - Fax:216-432-7253
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN104309163WP0809X, 364S00000X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0094014Medicaid
OH0959557Medicaid
OH2473961Medicaid
OH0959557Medicaid
OH0094014Medicaid
9922342Medicare ID - Type Unspecified
9922349Medicare ID - Type Unspecified
9922344Medicare ID - Type Unspecified