Provider Demographics
NPI:1487287009
Name:NELSON, MARCHAYE
Entity type:Individual
Prefix:
First Name:MARCHAYE
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27400 CHARDON RD APT 836
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44092-2772
Mailing Address - Country:US
Mailing Address - Phone:440-661-5564
Mailing Address - Fax:
Practice Address - Street 1:3100 E 45TH ST STE 314
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44127-1095
Practice Address - Country:US
Practice Address - Phone:216-441-9622
Practice Address - Fax:888-460-4717
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH72454493OtherOHIO ID