Provider Demographics
NPI:1912631359
Name:MERIDIETH, JODI LYNN (APRN, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:LYNN
Last Name:MERIDIETH
Suffix:
Gender:F
Credentials:APRN, WHNP-BC
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:LYNN
Other - Last Name:STEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, APRN
Mailing Address - Street 1:3401 ENTERPRISE PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-7343
Mailing Address - Country:US
Mailing Address - Phone:216-765-0500
Mailing Address - Fax:
Practice Address - Street 1:3401 ENTERPRISE PKWY STE 250
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7343
Practice Address - Country:US
Practice Address - Phone:216-765-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.395735163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse