Provider Demographics
NPI:1154186575
Name:FAWCETT, CLARE
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:FAWCETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7123 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-2802
Mailing Address - Country:US
Mailing Address - Phone:330-418-1119
Mailing Address - Fax:
Practice Address - Street 1:7123 CEDAR RD
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-2802
Practice Address - Country:US
Practice Address - Phone:330-418-1119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker