Provider Demographics
NPI:1265624795
Name:LUTHANEN, JOAN M (APRN, BC)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:LUTHANEN
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:M
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:12000 MCCRACKEN RD STE 157
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2962
Mailing Address - Country:US
Mailing Address - Phone:216-510-4765
Mailing Address - Fax:216-510-5046
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44193-1913
Practice Address - Country:US
Practice Address - Phone:216-510-4765
Practice Address - Fax:216-510-5046
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP09512363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health