Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | APRN.CNP.0029404 | OH |
NPI | 1013672500 |
---|---|
Provider Name | Allan Ehrenreich |
First Address | Euclid, OH 44119-1078 |
Second Address | Euclid, OH 44119-1078 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2021 |
Last Update Date | 01/11/2021 |