Black, Ira-Etta Marie

Black, Ira-Etta Marie is an sole proprietor health care provider with primary practice located at 2200 E 106Th St Apt #4, Cleveland OH 44106-4258. She recently has only one registered license in Nursing Service Providers / Case Management, which is considered as her primary health care specialty. Black, Ira-Etta Marie can be contacted via phone (216) 229-8882.

Contact Information

Primary practice address
2200 E 106Th St Apt #4 Cleveland OH 44106-4258
Phone: (216) 229-8882
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Case Management 163WC0400X RN237736 Ohio

Profile Details

NPI number 1669621256
LBN Legal business name Black, Ira-Etta Marie
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 18th, 2008
Last updated Sep 18th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669621256 NPPES
Ohio MEDICAID 2631610

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