Provider Demographics
NPI:1063029072
Name:STROZIER, JACQULINE Y
Entity Type:Individual
Prefix:
First Name:JACQULINE
Middle Name:Y
Last Name:STROZIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17415 ELDAMERE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-1709
Mailing Address - Country:US
Mailing Address - Phone:216-551-5142
Mailing Address - Fax:
Practice Address - Street 1:17415 ELDAMERE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-1709
Practice Address - Country:US
Practice Address - Phone:216-551-5142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide