Provider Demographics
NPI:1598414021
Name:NIGHTINGALE NP INC
Entity Type:Organization
Organization Name:NIGHTINGALE NP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:BLECH
Authorized Official - Suffix:
Authorized Official - Credentials:AGNP-C
Authorized Official - Phone:216-925-3441
Mailing Address - Street 1:160 E WASHINGTON ST UNIT 808
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-6443
Mailing Address - Country:US
Mailing Address - Phone:216-925-3440
Mailing Address - Fax:
Practice Address - Street 1:12340 BASS LAKE RD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-8327
Practice Address - Country:US
Practice Address - Phone:216-925-3440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0114565Medicaid