JILLIAN TAIT FETZNER NP-C NPI 1588060321

NPI Information

NPI: 1588060321
Provider Name: JILLIAN TAIT FETZNER, NP-C
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
10685 CARNEGIE AVE
CLEVELAND, OH
ZIP 44106
Phone: (216) 445-7634
Get Directions

Jillian Tait Fetzner, NP-C is an adult health nurse practitioner in Cleveland, OH with 19 years of experience. Jillian Tait Fetzner, NP-C NPI is 1588060321. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10685 CARNEGIE AVE
CLEVELAND, OH
ZIP 44106
Phone: (216) 445-7634
Fax: (216) 444-3474

The NPI 1588060321 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/5/2014 and was last updated on 2/15/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	COA16124	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0115025	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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