Provider Demographics
NPI:1811738719
Name:CLENNA, AUBREY (CNP)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:CLENNA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26600 GEORGE ZEIGER DR APT 902
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-7543
Mailing Address - Country:US
Mailing Address - Phone:216-571-5931
Mailing Address - Fax:
Practice Address - Street 1:22344 LAKE SHORE BLVD
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-1717
Practice Address - Country:US
Practice Address - Phone:216-815-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH443403163WW0101X
OH0036060363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory