Provider Demographics
NPI:1043405012
Name:WESLEY, CARRIE MONIQUE (RN)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:MONIQUE
Last Name:WESLEY
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5207 MARRUS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2972
Mailing Address - Country:US
Mailing Address - Phone:216-338-7481
Mailing Address - Fax:
Practice Address - Street 1:5207 MARRUS LN
Practice Address - Street 2:
Practice Address - City:RICHMOND HTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2972
Practice Address - Country:US
Practice Address - Phone:216-338-7481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 126795 IV164W00000X
OH377030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse