Doctor Name: | MARLA MARIE MECKLENBORG |
NPI Number: | 1184960882 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | RN16644 |
Business Practice Address: | 7227longfielddri. Madeira, OH - 45243 |
Business Phone Number: | 5132715164 |
Business Fax Number: | |
Mailing Address: | 7227longfielddrive, MADEIRA |
State: | OH |
Postal Code: | 45243 |
Phone Number: | 5132715164 |
Fax Number: | |
NPI Enumeration Date: | 12/27/2012 |
NPI Last Update Date: | 12/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WH0200X |
License Number: | RN16644 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Home Health |
Taxonomy Definition: |