Provider Demographics
NPI:1326751207
Name:RUSNAK, DANEENE
Entity Type:Individual
Prefix:
First Name:DANEENE
Middle Name:
Last Name:RUSNAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANEENE
Other - Middle Name:
Other - Last Name:MONROE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7344 PEARL RD STE 2B
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-9602
Mailing Address - Country:US
Mailing Address - Phone:440-625-0081
Mailing Address - Fax:440-625-0053
Practice Address - Street 1:7344 PEARL RD STE 2B
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-9602
Practice Address - Country:US
Practice Address - Phone:440-625-0081
Practice Address - Fax:440-625-0053
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.262080163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty