Provider Demographics
NPI:1396081311
Name:RAWLINSON, KEANA
Entity type:Individual
Prefix:
First Name:KEANA
Middle Name:
Last Name:RAWLINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KEANA
Other - Middle Name:
Other - Last Name:RAWLINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1761 E 236TH ST
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1956
Mailing Address - Country:US
Mailing Address - Phone:216-882-4747
Mailing Address - Fax:
Practice Address - Street 1:1761 E 236TH ST
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-1956
Practice Address - Country:US
Practice Address - Phone:216-882-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-19
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.482525163W00000X
OHPN148273-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse