Provider Demographics
NPI:1669034054
Name:LAMIELL, KAITLYN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:LAMIELL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:
Other - Last Name:PARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-444-6697
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-6697
Practice Address - Fax:216-636-6998
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-05
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024856363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily