Provider Demographics
NPI:1407353048
Name:SCHEFFER, MARILYN JEAN (LPN)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:JEAN
Last Name:SCHEFFER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1089 S CLEVE MASS RD
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-1659
Mailing Address - Country:US
Mailing Address - Phone:330-996-7296
Mailing Address - Fax:330-374-2649
Practice Address - Street 1:264 E CROSIER ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-2151
Practice Address - Country:US
Practice Address - Phone:330-996-7296
Practice Address - Fax:330-374-2649
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.058195.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse