Healthcare Provider Details

I. General information

NPI: 1336276229
Provider Name (Legal Business Name): MARSHA A FOREMAN II R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6335 CIMARRON RD
MOUNT PERRY OH
43760-9769
US

IV. Provider business mailing address

6335 CIMARRON RD
MOUNT PERRY OH
43760-9769
US

V. Phone/Fax

Practice location:
  • Phone: 174-078-7260
  • Fax:
Mailing address:
  • Phone: 174-078-7260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN-277163
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: