Healthcare Provider Details

I. General information

NPI: 1154693828
Provider Name (Legal Business Name): RONISHA MARION HALL LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2012
Last Update Date: 03/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

746 BEECHWOOD AVE APT 2
CINCINNATI OH
45232-1716
US

IV. Provider business mailing address

870 SOUTHMEADOW CIRCLE UNIT 201
CINCINNATI OH
45231-1716
US

V. Phone/Fax

Practice location:
  • Phone: 513-413-6226
  • Fax:
Mailing address:
  • Phone: 513-288-5246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number5012345
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number152-795
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: