Provider Demographics
NPI:1295334928
Name:LULFS, MARILYN L
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:L
Last Name:LULFS
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 1:878 BURR RD
Mailing Address - Street 2:
Mailing Address - City:WAUSEON
Mailing Address - State:OH
Mailing Address - Zip Code:43567-1657
Mailing Address - Country:US
Mailing Address - Phone:419-335-7023
Mailing Address - Fax:
Practice Address - Street 1:878 BURR RD
Practice Address - Street 2:
Practice Address - City:WAUSEON
Practice Address - State:OH
Practice Address - Zip Code:43567-1657
Practice Address - Country:US
Practice Address - Phone:419-335-7023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker