Provider Demographics
NPI:1346347630
Name:AULISIO, MARY SHIELDS (MSN, RN, CNP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:SHIELDS
Last Name:AULISIO
Suffix:
Gender:F
Credentials:MSN, RN, CNP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:HELEN
Other - Last Name:SHIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11100 EUCLID AVE
Mailing Address - Street 2:MAILSTOP 5035
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-844-7898
Mailing Address - Fax:216-844-1202
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:MAILSTOP 5035
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-7898
Practice Address - Fax:216-844-1202
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.252370-COA1363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care