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Individual

MICHELE A DULA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
20050 HARVARD AVE, SUITE 304, WARRENSVILLE HEIGHTS, OH 44122-6816
(216) 475-0440
Mailing address
20050 HARVARD AVE, SUITE 304, WARRENSVILLE HEIGHTS, OH 44122-6816
(216) 475-0440

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NP-03295
OH
363LP2300X
Primary Care Nurse Practitioner
Primary
NP-03295
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000363818
ANTHEM
OH
01
000000495738
ANTHEM
OH
05
2108945
OH
01
NP77891
MEDICARE PIN
OH
01
P00331716
MEDICARE PIN
OH
Enumeration date
12/14/2005
Last updated
12/30/2007
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