Mary Theresa Ronan, RN, BSN
Individual provider Active NPI Home Health Registered Nurse · Kimball, MI
NPI 1831483296 · NPPES record last updated Jun 2, 2011
Key facts
- NPI
- 1831483296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Registered Nurse 163WH0200X
- License
- 4704208728 (MI)
- Practice address
- 2763 W Lake Dr
Kimball, MI 48074-4603 - Phone
- (810) 984-8576
- NPI assigned
- Jun 2, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704208728 | MI | MD | Home Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 4704208728 | MI | Yes |
Addresses
Primary practice location
2763 W Lake Dr
Kimball, MI 48074-4603
Mailing address
2763 W Lake Dr
Kimball, MI 48074-4603
Phone (810) 984-8576
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4704208728 | Other | MI | DEPARTMENT OF COMMUNITY HEALTH - REGISTERED NURSE LICENSE |
Other providers in Kimball, MI
- Melissa Olshove
- Glenn Earl Parr
- R & R Senior Care
- Brenda Recker
- Luann Reynders
- John Rostine II
- Lisa Marie Rottman Adamson
- Edward Adam Rozanski
- Sacred Heart
- Darci Lee Schomburg
All providers in Kimball, MI · Home Health Registered Nurse in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.