Provider Demographics
NPI:1366691404
Name:KLONOWSKI, BRIAN (RN)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:KLONOWSKI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 KENTON AVE
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-4328
Mailing Address - Country:US
Mailing Address - Phone:440-887-0119
Mailing Address - Fax:
Practice Address - Street 1:8300 KENTON AVE
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-4328
Practice Address - Country:US
Practice Address - Phone:440-887-0119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-13
Last Update Date:2008-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.318035163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine