Provider Demographics
NPI:1417627985
Name:STETSURA, OLENA ALEXANDRA (NP)
Entity Type:Individual
Prefix:MRS
First Name:OLENA
Middle Name:ALEXANDRA
Last Name:STETSURA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13179 FAIRWINDS DR
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-7945
Mailing Address - Country:US
Mailing Address - Phone:216-990-6744
Mailing Address - Fax:
Practice Address - Street 1:13179 FAIRWINDS DR
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-7945
Practice Address - Country:US
Practice Address - Phone:216-990-6744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029782363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health