Provider Demographics
NPI:1356774301
Name:PUPOVAC, ANDJELINA (CNP)
Entity type:Individual
Prefix:
First Name:ANDJELINA
Middle Name:
Last Name:PUPOVAC
Suffix:
Gender:F
Credentials:CNP
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Other - Credentials:
Mailing Address - Street 1:33100 CLEVELAND CLINIC BLVD
Mailing Address - Street 2:RICHARD E. JACOBS HEALTH CENETER AVW2-1
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-1390
Mailing Address - Country:US
Mailing Address - Phone:216-798-3413
Mailing Address - Fax:440-695-4639
Practice Address - Street 1:33100 CLEVELAND CLINIC BLVD
Practice Address - Street 2:RICHARD E. JACOBS HEALTH CENETER AVW2-1
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-1390
Practice Address - Country:US
Practice Address - Phone:216-798-3413
Practice Address - Fax:440-695-4639
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHCOA.14990-NP363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care