Provider Demographics
NPI:1578872552
Name:MIERZEJEWSKI, KATHLEEN P (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:P
Last Name:MIERZEJEWSKI
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-1243
Mailing Address - Country:US
Mailing Address - Phone:216-212-5594
Mailing Address - Fax:
Practice Address - Street 1:1728 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-1243
Practice Address - Country:US
Practice Address - Phone:216-212-5594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN364645163WH0200X, 163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice