Healthcare Provider Details

I. General information

NPI: 1871498121
Provider Name (Legal Business Name): CARRIE MORANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 EDGEFIELD DR
CLEVES OH
45002-1406
US

IV. Provider business mailing address

114 EDGEFIELD DR
CLEVES OH
45002-1406
US

V. Phone/Fax

Practice location:
  • Phone: 513-708-8434
  • Fax:
Mailing address:
  • Phone: 513-708-8434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number302528
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: