Healthcare Provider Details

I. General information

NPI: 1912197047
Provider Name (Legal Business Name): TONI L MAROO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 KARL RD
COLUMBUS OH
43229-3602
US

IV. Provider business mailing address

3378 MANN RD
BLACKLICK OH
43004-8719
US

V. Phone/Fax

Practice location:
  • Phone: 216-403-9090
  • Fax:
Mailing address:
  • Phone: 614-618-3084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.0028938
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: