Provider Demographics
NPI:1083834469
Name:FLUELLEN, DARLENE MARIE
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:MARIE
Last Name:FLUELLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 ROSSMOOR RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2516
Mailing Address - Country:US
Mailing Address - Phone:216-321-1337
Mailing Address - Fax:216-321-1337
Practice Address - Street 1:2119 ROSSMOOR RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-2516
Practice Address - Country:US
Practice Address - Phone:216-321-1337
Practice Address - Fax:216-321-1337
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN111785164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse