Provider Demographics
NPI:1285296228
Name:GIULIANELLI, CHERLYN RENAE
Entity type:Individual
Prefix:
First Name:CHERLYN
Middle Name:RENAE
Last Name:GIULIANELLI
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 1:1402 W 14 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-1499
Mailing Address - Country:US
Mailing Address - Phone:248-435-7314
Mailing Address - Fax:
Practice Address - Street 1:1402 W 14 MILE RD
Practice Address - Street 2:
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-1499
Practice Address - Country:US
Practice Address - Phone:248-435-7314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-30
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704238977363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily