Provider Demographics
NPI:1437997483
Name:SHULIK, DIANA L (RN BSN)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:L
Last Name:SHULIK
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34806 LAKE SHORE BLVD APT F
Mailing Address - Street 2:
Mailing Address - City:EASTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44095-2097
Mailing Address - Country:US
Mailing Address - Phone:440-865-2335
Mailing Address - Fax:440-525-5851
Practice Address - Street 1:34806 LAKE SHORE BLVD APT F
Practice Address - Street 2:
Practice Address - City:EASTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44095-2097
Practice Address - Country:US
Practice Address - Phone:440-865-2335
Practice Address - Fax:440-525-5851
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.461620163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health