JILLIAN TAIT FETZNER (NPI# 1588060321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588060321 |
Entity Type | Individual |
Full Name | JILLIAN TAIT FETZNER |
Other Name | JILLIAN TAIT JOHNSON |
Credential | NP-C |
Practice Address |
10685 Carnegie Ave Cleveland OH 44106 |
Practice Telephone | 2164457634 |
Practice Fax Number | 2164443474 |
Mailing Telephone | 2164457634 |
Mailing Fax Number | 2164443474 |
Enumeration Date | 2014-11-05 |
Last Update Date | 2019-02-15 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
COA16124 | OH | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OH | 0115025 | 05 |
Street Address |
10685 CARNEGIE AVE |
City | CLEVELAND |
State | OH |
Zip Code | 44106 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538165626 | Cleveland Foot and Ankle Clinic | Clinic/Center | 10685 Carnegie Ave, Cleveland, OH 44106-3018 | 2005-06-23 |
1114388386 | Erin Michiko Daigle | Nurse Practitioner | 10685 Carnegie Ave, Cleveland, OH 44106 | 2016-03-15 |
1164702684 | Melissa Ann Matteo | Dietitian, Registered | 10685 Carnegie Ave, Cleveland, OH 44112 | 2011-08-29 |
1649579178 | Diana Isaacs | Pharmacist | 10685 Carnegie Ave, Cleveland, OH 44195-1501 | 2011-03-23 |
1104012111 | Dawn Noe | Dietitian, Registered | 10685 Carnegie Ave, X20, Cleveland, OH 44106-3018 | 2007-09-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295347706 | Adeeb Oweidat | Anesthesiology | 1999 Circle Drive Centric, Apartment 417, Cleveland, OH 44106 | 2020-08-18 |
1104434240 | Bradly Miner | Student in an Organized Health Care Education/Training Program | Health Education Campus, 9501 Euclid Ave, Cleveland, OH 44106 | 2020-07-15 |
1306466974 | Ho Jun Lee | Student in an Organized Health Care Education/Training Program | 11100 Euclid Ave University Hospitals Cleveland Medical, Cleveland, OH 44106 | 2020-04-23 |
1528687837 | Shaleeka Cornelius | Student in an Organized Health Care Education/Training Program | 11100 Euclid Avenue Han 5042, University Hospitals Cleveland Medical Center, Cleveland, OH 44106 | 2020-04-16 |
1598393175 | Mikdat Ulas | Student in an Organized Health Care Education/Training Program | 111000 Euclid Avenue, Cleveland, OH 44106 | 2020-03-30 |
1790335651 | Michelle Clark | Home Health Aide | 1794 E 87th St, Cleveland, OH 44106 | 2019-09-12 |
1881246783 | Oziel Valdez Sanchez | Student in an Organized Health Care Education/Training Program | 11900 Euclid Ave, Cleveland, OH 44106 | 2019-07-10 |
1487216842 | Betina Griens Porto | Dentist | 9601 Chester Avenue, Case Western Reserve School of Dental Medicine, Cleveland, OH 44106 | 2019-07-05 |
1407417140 | Rebecca Petts | Dentist | 9601 Chester Ave, Cleveland, OH 44106 | 2019-06-24 |
1023677259 | Moeen Al Weshah | Student in an Organized Health Care Education/Training Program | 9601 Chester Ave # 239j3, Cleveland, OH 44106 | 2019-06-11 |
Find all providers in zip 44106 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629694153 | Laraine Elizabeth Tench | Nurse Practitioner | 9500 Euclid Ave # G110, Cleveland, OH 44195-0001 | 2020-06-20 |
1124578349 | Nancy Kempke | Nurse Practitioner | 9500 Euclid Ave Fa20, Cleveland, OH 44195 | 2016-10-12 |
1356708911 | Anne Debra Feldman | Nurse Practitioner | 9500 Euclid Ave # A31, Cleveland, OH 44195-0001 | 2016-01-26 |
1194131417 | Stephanie S Daniels | Nurse Practitioner | 1730 W 25th Street, Cleveland, OH 44113-3108 | 2014-07-08 |
1073954103 | Jessica Lauren Orleman | Nurse Practitioner | Cleveland Clinic Desk A90, 9500 Euclid Avenue, Cleveland, OH 44195-0001 | 2013-07-17 |
1366784902 | Deneen M Abston | Nurse Practitioner | 9500 Euclid Ave # Desku10, Cleveland, OH 44195-0001 | 2013-03-21 |
1467793778 | Teresa M Evans-guyton | Nurse Practitioner | 11201 Shaker Blvd Ste 240, Cleveland, OH 44104 | 2013-03-12 |
1174872543 | Sarah Ann Blowers | Nurse Practitioner | 17876 St. Clair Avenue, Cleveland, OH 44110 | 2012-08-31 |
1609121045 | Bridgett Ann Harr | Nurse Practitioner | 9500 Euclid Ave # T28, Cleveland, OH 44195-0001 | 2012-07-23 |
1093071458 | Josephina Puskas | Nurse Practitioner | 2050 East 96 Th Street, Cleveland, OH 44195 | 2012-04-10 |
Find all providers in CLEVELAND |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.