Provider Demographics
NPI:1235950403
Name:MAGWOOD, IVORY ANN (NURSING)
Entity type:Individual
Prefix:MISS
First Name:IVORY
Middle Name:ANN
Last Name:MAGWOOD
Suffix:
Gender:F
Credentials:NURSING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3418 W 127TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-2622
Mailing Address - Country:US
Mailing Address - Phone:216-213-9137
Mailing Address - Fax:
Practice Address - Street 1:3418 W 127TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-2622
Practice Address - Country:US
Practice Address - Phone:216-213-9137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH402259570420376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide