Provider Demographics
NPI:1811016769
Name:CARIAS, MIRNA I (CNP)
Entity Type:Individual
Prefix:
First Name:MIRNA
Middle Name:I
Last Name:CARIAS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:MIRNA
Other - Middle Name:I
Other - Last Name:CORRIGAN-CARIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10701 EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1702
Mailing Address - Country:US
Mailing Address - Phone:216-791-3800
Mailing Address - Fax:216-229-2891
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:216-229-2891
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH241402163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCONP76211OtherMEDICARE
OH2261305Medicaid
OH2261305Medicaid