Marilyn Jane Boros, CNP
Individual provider Active NPI Family Nurse Practitioner · Lakewood, OH
NPI 1184089229 · NPPES record last updated Dec 16, 2015
Key facts
- NPI
- 1184089229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- COA.18216-NP (OH)
- Practice address
- 16110 Detroit Ave
Lakewood, OH 44107-3715 - Phone
- (216) 228-7878
- Fax
- (216) 529-5051
- NPI assigned
- Dec 16, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA.18216-NP | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthcare 2000 Community Clinic Inc | Current |
Accepting new patients | |
| Healthcare 2000 Community Clinic Inc | Current |
Accepting new patients |
Locations
1874 Cleveland Rd
Wooster, OH 44691
Phone (330) 262-2500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | COA.18216-NP | OH | Yes |
Addresses
Primary practice location
16110 Detroit Ave
Lakewood, OH 44107-3715
Mailing address
16110 Detroit Avenue
Lakewood, OH 44107
Phone (216) 228-7878
Other providers in Lakewood, OH
- Candice Boddy
- Victoria M. Bodner
- Laura Bolin
- Shirin Boose
- Mark William Boron
- Jennifer Borovica
- Kevin L. Borst
- Lauren Boudon
- Margaret Bour
- Janice Elaine Bowman
All providers in Lakewood, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.