Individual provider · Type 1 NPI

Sally Mae Shull-Diener, CNP

Nurse Practitioner · Toledo, OH

NPI number 1629028477 Active

Practice location

4640 W Alexis Rd
Toledo, OH 43623-1006

Fax (419) 479-2579

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XNP08368 (OH)

Nurse Practitioner: (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 wit…

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About NPI 1629028477

Sally Mae Shull-Diener, CNP's National Provider Identifier is 1629028477, issued on May 11, 2006. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Toledo, OH. The record was last updated on Sep 29, 2026.