Provider Demographics
NPI:1407007966
Name:ALLEN-CAGE, MARVELYN L (NP)
Entity Type:Individual
Prefix:MS
First Name:MARVELYN
Middle Name:L
Last Name:ALLEN-CAGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211699
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-3699
Mailing Address - Country:US
Mailing Address - Phone:866-849-0692
Mailing Address - Fax:
Practice Address - Street 1:3700 PARK EAST DR STE 450
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4318
Practice Address - Country:US
Practice Address - Phone:800-338-6833
Practice Address - Fax:888-973-8821
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH16519363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner