Individual provider Active NPI

Marceal Lynn Wyldes, RN, BSN, CPN

  • Pediatric Registered Nurse
  • Parma, OH
National Provider Identifier
1578878922
Registry record updated Aug 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
RN281630 Issued in OH
Practice address
3710 Redfern Rd
Parma, OH 44134-3354
Phone
(440) 552-7061
NPI assigned
Aug 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X RN281630 OH Primary

Addresses

Primary practice location

3710 Redfern Rd
Parma, OH 44134-3354

Mailing address

3710 Redfern Rd
Parma, OH 44134-3354
Phone (440) 552-7061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN281630OHMDPediatric Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1578878922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 REDFERN RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441343354",
            "telephone_number": "440-552-7061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 REDFERN RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441343354",
            "telephone_number": "440-552-7061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLDES",
        "first_name": "MARCEAL",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RN, BSN, CPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "OH",
            "license": "RN281630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.