Provider Demographics
NPI:1821793233
Name:FAUTH, MIKAYLA PAIGE (ACNPC-AG)
Entity Type:Individual
Prefix:MRS
First Name:MIKAYLA
Middle Name:PAIGE
Last Name:FAUTH
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 MAYFIELD CT
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-1331
Mailing Address - Country:US
Mailing Address - Phone:440-506-8025
Mailing Address - Fax:
Practice Address - Street 1:33300 CLEVELAND CLINIC BLVD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-1172
Practice Address - Country:US
Practice Address - Phone:440-695-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH436743363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care