Individual provider Active NPI

Marlem Michelena, APRN

  • Family Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1790674810
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0039672 Issued in OH
Practice address
10803 Lake Ave Apt 104
Cleveland, OH 44102-1249
Phone
(561) 246-0192
NPI assigned
Jul 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11040605 FL
Family Nurse Practitioner 363LF0000X 0039672 OH Primary

Addresses

Primary practice location

10803 Lake Ave Apt 104
Cleveland, OH 44102-1249

Mailing address

10803 Lake Ave Apt 104
Cleveland, OH 44102-1249
Phone (561) 246-0192

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

State licenses

LicenseStateTypeSpecialty
11040605FLMDFamily Nurse Practitioner
0039672OHMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1790674810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10803 LAKE AVE APT 104",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441021249",
            "telephone_number": "561-246-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10803 LAKE AVE APT 104",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441021249",
            "telephone_number": "561-246-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELENA",
        "first_name": "MARLEM",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-02",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11040605",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0039672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.