Provider Demographics
NPI:1588995849
Name:TRAVELING NURSE PRACTITIONER, LLC
Entity type:Organization
Organization Name:TRAVELING NURSE PRACTITIONER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:330-590-0847
Mailing Address - Street 1:200 SMOKERISE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-7401
Mailing Address - Country:US
Mailing Address - Phone:330-590-0847
Mailing Address - Fax:234-201-7644
Practice Address - Street 1:200 SMOKERISE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-7401
Practice Address - Country:US
Practice Address - Phone:330-590-0847
Practice Address - Fax:234-201-7644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Multi-Specialty