Provider Demographics
NPI:1821128653
Name:SCHLEYER, MARILYN (ARNP, PHD)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:
Last Name:SCHLEYER
Suffix:
Gender:F
Credentials:ARNP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:KY
Mailing Address - Zip Code:41073-1040
Mailing Address - Country:US
Mailing Address - Phone:859-380-6155
Mailing Address - Fax:
Practice Address - Street 1:227 FAIRFIELD AVE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:KY
Practice Address - Zip Code:41073-1040
Practice Address - Country:US
Practice Address - Phone:859-380-6155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYARNP 2101S163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78001195Medicaid
KY78001195Medicaid