Healthcare Provider Details

I. General information

NPI: 1770943912
Provider Name (Legal Business Name): DARLEEN MYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2016
Last Update Date: 10/25/2021
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12300 MCCRACKEN RD
GARFIELD HEIGHTS OH
44125-2914
US

IV. Provider business mailing address

12300 MCCRACKEN RD
GARFIELD HEIGHTS OH
44125-2914
US

V. Phone/Fax

Practice location:
  • Phone: 216-581-0500
  • Fax:
Mailing address:
  • Phone: 216-581-0500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCOA.18868-NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCOA.18868-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: