Healthcare Provider Details

I. General information

NPI: 1174513055
Provider Name (Legal Business Name): CHERYL L MALONEY RN, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 02/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 JOSEPH E. SANKER BOULEVARD THE UROLOGY CENTER
CINCINNATI OH
45212
US

IV. Provider business mailing address

4549 RAYNOR COUR OUTPATIENT ANESTHESIA SPECIALISTS
MASON OH
45040
US

V. Phone/Fax

Practice location:
  • Phone: 513-841-7600
  • Fax: 513-841-7601
Mailing address:
  • Phone: 513-204-5696
  • Fax: 877-284-4283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number182428
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: