Healthcare Provider Details

I. General information

NPI: 1083682819
Provider Name (Legal Business Name): ROBERTA MURE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 OAK ST
CINCINNATI OH
45219-2598
US

IV. Provider business mailing address

411 OAK STREET
CINCINNATI OH
45219
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-1800
  • Fax: 513-984-4909
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberR0059737
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: