Darlene Maxwell, PSN NURSE
Individual provider Active NPI Licensed Practical Nurse · Cuclid, OH
NPI 1487728945 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487728945
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- PN091058 (OH)
- Practice address
- 27800 Sidney
Cuclid, OH 44132 - Phone
- (216) 731-9103
- NPI assigned
- Nov 17, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN091058 | OH | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN091058 | OH | Yes |
Addresses
Primary practice location
27800 Sidney
Cuclid, OH 44132
Mailing address
17705 Rookhill Circle
Cleveland, OH 44112
Phone (216) 692-3226
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PIN2667 | Medicaid | OH |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.