Provider Demographics
NPI:1255813804
Name:EICHLER, ELISSA (FNP)
Entity type:Individual
Prefix:
First Name:ELISSA
Middle Name:
Last Name:EICHLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ELISSA
Other - Middle Name:
Other - Last Name:EICHLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FCN
Mailing Address - Street 1:6975 W 130TH ST
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-7821
Mailing Address - Country:US
Mailing Address - Phone:440-888-7487
Mailing Address - Fax:440-345-5151
Practice Address - Street 1:6975 W 130TH ST
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-7821
Practice Address - Country:US
Practice Address - Phone:440-888-7487
Practice Address - Fax:440-345-5151
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023510363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2879461Medicaid