Provider Demographics
NPI:1144661984
Name:ST CLAIR STEPANEK, JESSICA DAWN
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:DAWN
Last Name:ST CLAIR STEPANEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:DAWN
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN, NP-C
Mailing Address - Street 1:6835 PARMA PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-4204
Mailing Address - Country:US
Mailing Address - Phone:216-832-2040
Mailing Address - Fax:
Practice Address - Street 1:25200 CENTER RIDGE RD
Practice Address - Street 2:SUITE 3400
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-4141
Practice Address - Country:US
Practice Address - Phone:440-331-4646
Practice Address - Fax:440-331-3197
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.14760-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health