Provider Demographics
NPI:1184334823
Name:COLVIN, ARISSA NYSHELL-MARIE
Entity type:Individual
Prefix:
First Name:ARISSA
Middle Name:NYSHELL-MARIE
Last Name:COLVIN
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 1:8919 CAPITOL AVE # UP
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44104-2312
Mailing Address - Country:US
Mailing Address - Phone:216-301-5573
Mailing Address - Fax:
Practice Address - Street 1:8919 CAPITOL AVE # UP
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-2312
Practice Address - Country:US
Practice Address - Phone:216-301-5573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker