Basic Information
| Provider Information | |||||||||
| NPI: | 1538473780 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STROUSE | ||||||||
| FirstName: | LEE | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 35980 MILDRED ST | ||||||||
| Address2: | |||||||||
| City: | N RIDGEVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440391512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4403159407 | ||||||||
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| Practice Location | |||||||||
| Address1: | 223 MILLER RD | ||||||||
| Address2: | |||||||||
| City: | AVON LAKE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440121004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4409302002 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2010 | ||||||||
| LastUpdateDate: | 07/29/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | NS-06226 | OH | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.