Healthcare Provider Details

I. General information

NPI: 1346937547
Provider Name (Legal Business Name): LARANE HULSMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37334 HARLOW DR
WILLOUGHBY OH
44094-5758
US

IV. Provider business mailing address

37334 HARLOW DR
WILLOUGHBY OH
44094-5758
US

V. Phone/Fax

Practice location:
  • Phone: 216-319-0563
  • Fax:
Mailing address:
  • Phone: 216-319-0563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: