| Doctor Name: | KAHLA GAGNE |
| NPI Number: | 1205221264 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RN.368003-COA17217 |
| Business Practice Address: | 1305 Stoney Run Trl Broadview Heights, OH - 441472555 |
| Business Phone Number: | 4403154511 |
| Business Fax Number: | |
| Mailing Address: | 11100 Euclid Ave, CLEVELAND |
| State: | OH |
| Postal Code: | 441061716 |
| Phone Number: | 2162865595 |
| Fax Number: | |
| NPI Enumeration Date: | 04/06/2015 |
| NPI Last Update Date: | 04/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | RN.368003-COA17217 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |