Provider Demographics
NPI:1235801358
Name:WENTZEL, SIERRA (FNP-C)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:
Last Name:WENTZEL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25350 ROCKSIDE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-7111
Mailing Address - Country:US
Mailing Address - Phone:216-961-8804
Mailing Address - Fax:440-374-4965
Practice Address - Street 1:1005 E STATE ST STE W
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2151
Practice Address - Country:US
Practice Address - Phone:740-593-6979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029854363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily