MEDICARE: DARNELLA NYEISHA WILSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist	005555	OH
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1255125977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARNELLA NYEISHA WILSON

Provider Business Mailing Address
First Line	:	824 E 95TH ST # A
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44108-2134
Country	:	US
Telephone Number	:	440-990-7793
Fax Number	:

Provider Business Practice Location Address
First Line	:	824 E 95TH ST # A
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44108-2134
Country	:	US
Telephone Number	:	440-990-7793
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2025
Last Update Date	:	02/05/2026

Similar Medicare Providers

1508264912 — SHAWN PAUL MOORE
Practice Location Address:

868 E 95TH ST
CLEVELAND, OH
44108-2134

Practice Phone: 216-202-1035
Practice Fax:

1134484959 — DR. WENDI O'NEILL DDS
Practice Location Address:

2103 CORNELL RD RM 2134
CLEVELAND, OH
44106-3860

Practice Phone: 614-270-2060
Practice Fax:

1942045083 — A NEW MILLENNIUM DENTISTRY
Practice Location Address:

6151 WILSON MILLS RD STE 250
CLEVELAND, OH
44143-2134

Practice Phone: 440-995-9999
Practice Fax:

1841143450 — MELVA ELIZABETH DARDEN PEER SUPPORTER
Practice Location Address:

661 E 103RD ST APT 312
CLEVELAND, OH
44108-4306

Practice Phone: 614-622-5798
Practice Fax:

1699628776 — JACQUELINE HARRIS-CLARK
Practice Location Address:

595 E 105TH ST APT 305
CLEVELAND, OH
44108-1379

Practice Phone: 440-444-2871
Practice Fax:

1922951912 — MS. JANIS KIYONO MACK
Practice Location Address:

910 E 129TH ST
CLEVELAND, OH
44108-2540

Practice Phone: 216-262-6485
Practice Fax:

Directions to “ DARNELLA NYEISHA WILSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.