Provider Demographics
NPI:1922553254
Name:NEMETH, CORRIE (CNP)
Entity Type:Individual
Prefix:
First Name:CORRIE
Middle Name:
Last Name:NEMETH
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:PO BOX 901543
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44190-2755
Mailing Address - Country:US
Mailing Address - Phone:440-250-2070
Mailing Address - Fax:440-250-2071
Practice Address - Street 1:960 CLAGUE RD STE 3201
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1588
Practice Address - Country:US
Practice Address - Phone:440-250-2070
Practice Address - Fax:440-250-2071
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNP.019721364SA2200X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1922553254Medicaid