Provider Demographics
NPI:1245680404
Name:SARUBBI, VANESSA NICOLE
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:NICOLE
Last Name:SARUBBI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 HARRIS RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1756
Mailing Address - Country:US
Mailing Address - Phone:216-482-5606
Mailing Address - Fax:
Practice Address - Street 1:425 HARRIS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND HTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1756
Practice Address - Country:US
Practice Address - Phone:216-482-5606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH153376164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse