Provider Demographics
NPI:1760765630
Name:JALIL, SAKINAH (CNP)
Entity Type:Individual
Prefix:
First Name:SAKINAH
Middle Name:
Last Name:JALIL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 KING GEORGE BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3408
Mailing Address - Country:US
Mailing Address - Phone:216-645-2478
Mailing Address - Fax:
Practice Address - Street 1:930 KING GEORGE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3408
Practice Address - Country:US
Practice Address - Phone:216-645-2478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN345615163WG0000X
OHAPRN.CNP025579363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice