Provider Demographics
NPI:1164680435
Name:DEARTH, CHRISTINE ANN (CNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ANN
Last Name:DEARTH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
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Mailing Address - Street 1:14601 DETROIT AVE
Mailing Address - Street 2:SUITE 540
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107
Mailing Address - Country:US
Mailing Address - Phone:216-529-5300
Mailing Address - Fax:216-529-5301
Practice Address - Street 1:14601 DETROIT AVE
Practice Address - Street 2:SUITE 540
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4214
Practice Address - Country:US
Practice Address - Phone:216-529-5300
Practice Address - Fax:216-529-5301
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2016-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH367211363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner