Provider Demographics
NPI:1497204929
Name:MEADE, MICHELLE N (APRNCNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:N
Last Name:MEADE
Suffix:
Gender:F
Credentials:APRNCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1952 REVERE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2234
Mailing Address - Country:US
Mailing Address - Phone:216-650-1070
Mailing Address - Fax:
Practice Address - Street 1:1952 REVERE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-2234
Practice Address - Country:US
Practice Address - Phone:216-650-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.425445163W00000X
OHAPRN.CNP.0033239363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse