Provider Demographics
NPI:1376606111
Name:RESSER, TINA SIMKA (MSN, ACNP-BC, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:SIMKA
Last Name:RESSER
Suffix:
Gender:F
Credentials:MSN, ACNP-BC, FNP-BC
Other - Prefix:MRS
Other - First Name:TINA
Other - Middle Name:SIMKA
Other - Last Name:RESSER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2796 ELLINGTON CT
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-4900
Mailing Address - Country:US
Mailing Address - Phone:440-937-9359
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:UNIT H22
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-4324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH05494363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily