Provider Demographics
NPI:1053173211
Name:MAGWOOD, DENA
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:
Last Name:MAGWOOD
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 1:24020 HERMITAGE RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4010
Mailing Address - Country:US
Mailing Address - Phone:216-258-6809
Mailing Address - Fax:
Practice Address - Street 1:1203 HASELTON RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44121-1500
Practice Address - Country:US
Practice Address - Phone:216-258-6809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH179891164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse