Provider Demographics
NPI:1790593713
Name:BEARS, AMY (RN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BEARS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4875 REDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44054-1540
Mailing Address - Country:US
Mailing Address - Phone:440-212-6166
Mailing Address - Fax:
Practice Address - Street 1:25 MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-6975
Practice Address - Country:US
Practice Address - Phone:440-558-8070
Practice Address - Fax:440-588-8071
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN398130163WA0400X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health