SALLY MAE SHULL-DIENER CNP
NPI 1629028477
Nurse Practitioner in Toledo, OH

Q: What is Sally Shull-diener's NPI number?

The NPI number for Sally Shull-diener is 1629028477. It was assigned to this individual provider in the NPPES registry on May 11, 2006.

Q: What is Sally Shull-diener's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since May 11, 2006

4640 W ALEXIS RD, TOLEDO, OH 43623(419) 843-8150(419) 479-2579 Get Directions Write a Review

NPPES record last updated: March 29, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Sally Mae Shull-diener Cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SALLY MAE SHULL-DIENER CNP (NPI 1629028477) is an individual nurse practitioner in Toledo, Ohio, licensed in Ohio (NP08368) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1629028477

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameSALLY MAE SHULL-DIENERCredential: CNP

Location Address4640 W ALEXIS RDToledo, OH 43623-1006

Mailing Address4640 W Alexis RdToledo, OH 43623-1006 · (419) 843-8150 · Fax (419) 479-2579

Phone(419) 843-8150

Fax(419) 479-2579

Sole ProprietorNo

Enumeration DateMay 11, 2006

Last NPPES UpdateMarch 29, 2011

✔ NPI 1629028477 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in OH · NP08368

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

4640 W ALEXIS RD, Toledo, OH 43623

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Other Identifiers 7

Other$$$$$$$$$-001OH · Mmoh

Other$$$$$$$$$-003OH · Mmoh

Medicare PINSHNP19553OH

Other000000475788OH · Anthem

OtherPENDINGOH · Anthem

OtherP00301721OH · Rrmc

Medicaid2614559OH

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIMOTHY B HACKER MD

Internal Medicine