Provider Demographics
NPI:1881666303
Name:WEST, MALIA R (CNP)
Entity type:Individual
Prefix:MS
First Name:MALIA
Middle Name:R
Last Name:WEST
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Gender:F
Credentials:CNP
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Mailing Address - Street 1:1170 E BROAD ST
Mailing Address - Street 2:STE 2
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-6351
Mailing Address - Country:US
Mailing Address - Phone:440-323-3574
Mailing Address - Fax:440-323-3552
Practice Address - Street 1:20455 LORAIN RD
Practice Address - Street 2:T-01
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-3494
Practice Address - Country:US
Practice Address - Phone:440-799-4224
Practice Address - Fax:440-799-4228
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2015-06-22
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Provider Licenses
StateLicense IDTaxonomies
OHNP-07666363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2636213Medicaid
OH2636213Medicaid
NP78751Medicare PIN