Provider Demographics
NPI:1336636232
Name:WESTOVER, JUSTINE LEE (CAA)
Entity Type:Individual
Prefix:MS
First Name:JUSTINE
Middle Name:LEE
Last Name:WESTOVER
Suffix:
Gender:F
Credentials:CAA
Other - Prefix:
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Mailing Address - Street 1:3168 HOUSTON RD
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-6315
Mailing Address - Country:US
Mailing Address - Phone:704-530-5563
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant