Healthcare Provider Details

I. General information

NPI: 1720598923
Provider Name (Legal Business Name): HOPE RENEE TOLLE CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 12/31/2020
Certification Date: 12/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 N WASHINGTON ST
GREENFIELD OH
45123-9780
US

IV. Provider business mailing address

1075 N WASHINGTON ST
GREENFIELD OH
45123-9780
US

V. Phone/Fax

Practice location:
  • Phone: 937-981-9444
  • Fax: 937-981-9448
Mailing address:
  • Phone: 937-981-9444
  • Fax: 983-981-9448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.021825
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: