Ethan John Smith
Nurse Anesthetist, Certified Registered in Cleveland, OH. Individual provider (NPI-1).
NPI number1801435599
StatusActive
Last updated in NPPESOct 8, 2021
Details
- NPI
- 1801435599
- Entity type
- Individual (NPI-1)
- Name
- Ethan John Smith
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 30, 2019
- Certification date
- Sep 23, 2021
- Last updated
- Oct 8, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | LE-00030982 | OH | Yes |
Practice location
9500 Euclid AveCleveland, OH 44195-0001
Phone 216-798-4658
Mailing address
6789 Mayfield HtsMayfield, OH 44124-1973
Phone 440-312-4500
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