Provider Demographics
NPI:1184946105
Name:LARYEA, UMMA K (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:UMMA
Middle Name:K
Last Name:LARYEA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10839 DREXEL AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44108-3608
Mailing Address - Country:US
Mailing Address - Phone:216-451-0235
Mailing Address - Fax:
Practice Address - Street 1:10839 DREXEL AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-3608
Practice Address - Country:US
Practice Address - Phone:216-451-0235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH310737163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health