Provider Demographics
NPI:1316034077
Name:PEARL, JEANNE OLGA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:OLGA
Last Name:PEARL
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5265 MARIAN DR
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1228
Mailing Address - Country:US
Mailing Address - Phone:440-449-2782
Mailing Address - Fax:
Practice Address - Street 1:5265 MARIAN DR
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-1228
Practice Address - Country:US
Practice Address - Phone:440-449-2782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH102215163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care