Provider Demographics
NPI:1912602954
Name:ENGEL, MARYANNE (RN)
Entity Type:Individual
Prefix:
First Name:MARYANNE
Middle Name:
Last Name:ENGEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4603 FARLEY DR
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-1021
Mailing Address - Country:US
Mailing Address - Phone:440-478-3765
Mailing Address - Fax:
Practice Address - Street 1:4603 FARLEY DR
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-1021
Practice Address - Country:US
Practice Address - Phone:440-478-3765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker