Provider Demographics
NPI:1326289794
Name:GAJDA, MEREDITH B (CNP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:B
Last Name:GAJDA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7956 TYLER BLVD
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-4806
Mailing Address - Country:US
Mailing Address - Phone:440-255-4455
Mailing Address - Fax:440-255-3637
Practice Address - Street 1:7956 TYLER BLVD
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-4806
Practice Address - Country:US
Practice Address - Phone:440-255-4455
Practice Address - Fax:440-255-4487
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.09971363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner