Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN.CNP.0030098 | OH |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN.CNP.0030098 | OH |
NPI | 1003577313 |
---|---|
Provider Name | Marie Balcerski |
First Address | Kirtland, OH 44094-5190 |
Second Address | Cleveland, OH 44195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2022 |
Last Update Date | 26/01/2022 |