Provider Demographics
NPI:1376254037
Name:OUEDRAOGO, MARLESHA
Entity Type:Individual
Prefix:MRS
First Name:MARLESHA
Middle Name:
Last Name:OUEDRAOGO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARLESHA
Other - Middle Name:
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:780 TRIPLETT BLVD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-3421
Mailing Address - Country:US
Mailing Address - Phone:330-217-2416
Mailing Address - Fax:
Practice Address - Street 1:780 TRIPLETT BLVD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-3421
Practice Address - Country:US
Practice Address - Phone:330-217-2416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide