Provider Demographics
NPI:1578820924
Name:ADVANTAGE NURSE PRACTITIONERS, LLC
Entity Type:Organization
Organization Name:ADVANTAGE NURSE PRACTITIONERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MURDELL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:440-227-3629
Mailing Address - Street 1:29327 BUCKTHORN PL
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2971
Mailing Address - Country:US
Mailing Address - Phone:440-227-3629
Mailing Address - Fax:440-934-6147
Practice Address - Street 1:29327 BUCKTHORN PL
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2971
Practice Address - Country:US
Practice Address - Phone:440-227-3629
Practice Address - Fax:440-934-6147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH07830363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty