Provider Demographics
NPI:1194205856
Name:CROSS, ROXANNE NATASA (LPN, RN)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:NATASA
Last Name:CROSS
Suffix:
Gender:F
Credentials:LPN, RN
Other - Prefix:
Other - First Name:ROXANNE
Other - Middle Name:NATASA
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2108 S BELVOIR BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3712
Mailing Address - Country:US
Mailing Address - Phone:216-201-0608
Mailing Address - Fax:
Practice Address - Street 1:2108 S BELVOIR BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3712
Practice Address - Country:US
Practice Address - Phone:216-201-0608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.531103163W00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse