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Contact Information

PROVIDERGENIX LLC
3100 E 45TH ST STE 234
CLEVELAND, OH44127-1091
 Phone: 419-406-0067
 Fax: 866-309-3044
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

363LP2300X 50 Nurse Practitioner
 

Addiction (Substance Use Disorder)

163WA0400X
 

Addiction Psychiatry

2084P0802X 86 Physician/Neuropsychiatry
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

General Practice

163WG0000X
 

Home Health

163WH0200X
 

Infusion Therapy

163WI0500X
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Psychiatric/Mental Health

163WP0808X
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for PROVIDERGENIX LLC · (Female)

NPI Number 1194327098
Status Active
Credentials
Entity Individual
Enumeration date 11/15/2020
Last updated 11/15/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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