Provider Demographics
NPI:1174345045
Name:VINZANT, CIARA RENEE
Entity type:Individual
Prefix:MRS
First Name:CIARA
Middle Name:RENEE
Last Name:VINZANT
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CIARA
Other - Middle Name:RENEE
Other - Last Name:HUMPHREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18309 CHAGRIN BLVD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4846
Mailing Address - Country:US
Mailing Address - Phone:330-329-0560
Mailing Address - Fax:
Practice Address - Street 1:3043 SUPERIOR AVE E
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-4349
Practice Address - Country:US
Practice Address - Phone:216-307-1538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula