Provider Demographics
NPI:1376026005
Name:EVOLVING NURSE
Entity Type:Organization
Organization Name:EVOLVING NURSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEVELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-865-1148
Mailing Address - Street 1:2940 NOBLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2242
Mailing Address - Country:US
Mailing Address - Phone:216-865-1148
Mailing Address - Fax:440-424-5285
Practice Address - Street 1:2940 NOBLE RD STE 100
Practice Address - Street 2:
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44121-2242
Practice Address - Country:US
Practice Address - Phone:216-865-1148
Practice Address - Fax:440-424-5285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health