Healthcare Provider Details

I. General information

NPI: 1851618300
Provider Name (Legal Business Name): MARY CAROLINE TOHER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 07/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 CLIFTON RD NE, 6TH FLOOR CHILDREN'S AT EGLESTON-LIVER TRANSPLANT
ATLANTA GA
30322
US

IV. Provider business mailing address

1405 CLIFTON RD NE, 6TH FLOOR CHILDREN'S AT EGLESTON-LIVER TRANSPLANT
ATLANTA GA
30322
US

V. Phone/Fax

Practice location:
  • Phone: 800-605-6175
  • Fax:
Mailing address:
  • Phone: 404-785-1213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN198156
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: