Healthcare Provider Details

I. General information

NPI: 1851484877
Provider Name (Legal Business Name): BONNIE TOBIAS RN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 MANCHESTER RD
MIDDLETOWN OH
45042-2655
US

IV. Provider business mailing address

3008 MANCHESTER RD
MIDDLETOWN OH
45042-2655
US

V. Phone/Fax

Practice location:
  • Phone: 513-425-7265
  • Fax:
Mailing address:
  • Phone: 513-425-7265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN . 247460
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: