Individual
MARILYN CULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17415 EDGEWATER DR, LAKEWOOD, OH 44107-1119
(216) 310-0653
Mailing address
17415 EDGEWATER DR, LAKEWOOD, OH 44107-1119
(216) 310-0653
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
173750
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.10383
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
173750
RN
OH
05
—
3028673
—
OH
Enumeration date
10/16/2008
Last updated
09/14/2020
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