Provider Demographics
NPI:1518572890
Name:SLANE, MARLA J
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:J
Last Name:SLANE
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 1:18015 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:RICHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:43344-9777
Mailing Address - Country:US
Mailing Address - Phone:740-225-8387
Mailing Address - Fax:
Practice Address - Street 1:18015 MILLER RD APT A
Practice Address - Street 2:
Practice Address - City:RICHWOOD
Practice Address - State:OH
Practice Address - Zip Code:43344-9777
Practice Address - Country:US
Practice Address - Phone:740-225-4459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-13
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No374U00000XNursing Service Related ProvidersHome Health Aide