Provider Demographics
NPI:1396200150
Name:PFEISTER, JOHN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:PFEISTER
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3619 PARK EAST DR
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4330
Mailing Address - Country:US
Mailing Address - Phone:216-464-6211
Mailing Address - Fax:
Practice Address - Street 1:3619 PARK EAST DR
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4330
Practice Address - Country:US
Practice Address - Phone:216-464-6211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH024122363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health