Provider Demographics
NPI:1588644645
Name:NOVISKI, DENISE (CRNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:NOVISKI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10085 DARROW RD
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-1409
Mailing Address - Country:US
Mailing Address - Phone:330-425-4300
Mailing Address - Fax:330-963-3933
Practice Address - Street 1:10085 DARROW RD
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-1409
Practice Address - Country:US
Practice Address - Phone:330-425-4300
Practice Address - Fax:330-963-3933
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2022-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP08214363LF0000X
OH08214363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNONP20012Medicare UPIN