Provider Demographics
NPI:1043622905
Name:FIRRELL, AMY BETH (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:BETH
Last Name:FIRRELL
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:BETH
Other - Last Name:MEGERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:20050 HARVARD ROAD SUITE 106
Mailing Address - Street 2:SOUTH POINTE HOSPITAL
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-491-7036
Mailing Address - Fax:216-491-7776
Practice Address - Street 1:20050 HARVARD ROAD SUITE 106
Practice Address - Street 2:SOUTH POINTE HOSPITAL
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-491-7036
Practice Address - Fax:216-491-7776
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH15802-NP363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0159458Medicaid