Healthcare Provider Details

I. General information

NPI: 1861171621
Provider Name (Legal Business Name): EMILY ANN CIONI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 TIMBER DR
VALPARAISO IN
46385-9685
US

IV. Provider business mailing address

76 TIMBER DR
VALPARAISO IN
46385-9685
US

V. Phone/Fax

Practice location:
  • Phone: 219-798-5848
  • Fax:
Mailing address:
  • Phone: 219-798-5848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number28279528A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: