Provider Demographics
NPI:1508667882
Name:CLEVELAND, CIARA SHAE (RN PHN)
Entity type:Individual
Prefix:
First Name:CIARA
Middle Name:SHAE
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:RN PHN
Other - Prefix:
Other - First Name:CIARA
Other - Middle Name:SHAE
Other - Last Name:SCHEITHAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:405 N MANTORVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:KASSON
Mailing Address - State:MN
Mailing Address - Zip Code:55944-1365
Mailing Address - Country:US
Mailing Address - Phone:715-922-0327
Mailing Address - Fax:
Practice Address - Street 1:405 N MANTORVILLE AVE
Practice Address - Street 2:
Practice Address - City:KASSON
Practice Address - State:MN
Practice Address - Zip Code:55944-1365
Practice Address - Country:US
Practice Address - Phone:715-922-0327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2478635163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse