Provider Demographics
NPI:1265731129
Name:MAYFIELD, WANYAH
Entity type:Individual
Prefix:
First Name:WANYAH
Middle Name:
Last Name:MAYFIELD
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 1:6005 FLEET AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-3407
Mailing Address - Country:US
Mailing Address - Phone:216-223-8723
Mailing Address - Fax:844-325-0445
Practice Address - Street 1:6005 FLEET AVE STE 102
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-3407
Practice Address - Country:US
Practice Address - Phone:216-223-8723
Practice Address - Fax:844-325-0445
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-17
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide