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General NPI Number Information
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NPI Number | 1043405012
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Entity Type | Individual
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Provider Name | CARRIE MONIQUE WESLEY RN
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Gender | Female
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 5207 MARRUS LN
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City | RICHMOND HTS
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State | OH
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Zip | 44143-2972
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Country | US
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Telephone | 216-338-7481
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Fax |
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Provider Business Mailing Address
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Address Line | 5207 MARRUS LN
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City | RICHMOND HEIGHTS
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State | OH
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Zip | 44143-2972
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Country | US
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Telephone | 216-338-7481
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN. 126795 IV
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 377030
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License Number State | OH
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