Healthcare Provider Details

I. General information

NPI: 1962452169
Provider Name (Legal Business Name): MARIA A. HUSSEY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 04/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5209 DETROIT AVE
CLEVELAND OH
44102-2224
US

IV. Provider business mailing address

5209 DETROIT AVE
CLEVELAND OH
44102-2224
US

V. Phone/Fax

Practice location:
  • Phone: 216-651-2037
  • Fax:
Mailing address:
  • Phone: 216-651-2037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number1042624
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number134450
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3001042
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3001042
License Number StateKY
# 5
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number00298
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: