Provider Demographics
NPI:1568530608
Name:NEVULIS, ANITA ANN (RN)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:ANN
Last Name:NEVULIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29417 SAYLE DR
Mailing Address - Street 2:
Mailing Address - City:WICKLIFFE
Mailing Address - State:OH
Mailing Address - Zip Code:44092-1462
Mailing Address - Country:US
Mailing Address - Phone:440-833-0317
Mailing Address - Fax:
Practice Address - Street 1:29417 SAYLE DR
Practice Address - Street 2:
Practice Address - City:WICKLIFFE
Practice Address - State:OH
Practice Address - Zip Code:44092-1462
Practice Address - Country:US
Practice Address - Phone:440-833-0317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN285142163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse