Provider Demographics
NPI:1861094930
Name:HARPER, MARLENE RENEE
Entity type:Individual
Prefix:MRS
First Name:MARLENE
Middle Name:RENEE
Last Name:HARPER
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 1:7897 NEWPORT RD SE
Mailing Address - Street 2:
Mailing Address - City:UHRICHSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44683-6351
Mailing Address - Country:US
Mailing Address - Phone:330-401-7847
Mailing Address - Fax:
Practice Address - Street 1:7897 NEWPORT RD SE
Practice Address - Street 2:
Practice Address - City:UHRICHSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44683-6351
Practice Address - Country:US
Practice Address - Phone:330-401-7847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0246688Medicaid