Provider Demographics
NPI:1700471588
Name:MCNAMARA, DENISE (BSN, RN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:MCNAMARA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:24340 SPERRY DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1565
Mailing Address - Country:US
Mailing Address - Phone:440-250-5400
Mailing Address - Fax:866-420-9667
Practice Address - Street 1:24340 SPERRY DR
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1565
Practice Address - Country:US
Practice Address - Phone:440-250-5400
Practice Address - Fax:866-420-9667
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN225593163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN225593OtherNURSING LICENSE STATE OF OHIO
OHRN225593OtherSTATE OF OHIO NURSING LICENSE