Provider Demographics
NPI:1942079728
Name:SCHLEUSE, MARIELA JURMAN
Entity Type:Individual
Prefix:
First Name:MARIELA
Middle Name:JURMAN
Last Name:SCHLEUSE
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 1:12149 BELLE TERRE DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:AR
Mailing Address - Zip Code:72002-9448
Mailing Address - Country:US
Mailing Address - Phone:469-243-0425
Mailing Address - Fax:
Practice Address - Street 1:9015 DAILEY DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-6215
Practice Address - Country:US
Practice Address - Phone:501-364-6560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR107603163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse