Provider Demographics
NPI:1447227558
Name:TITUS, MONA (RN)
Entity Type:Individual
Prefix:MRS
First Name:MONA
Middle Name:
Last Name:TITUS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:MONA
Other - Middle Name:
Other - Last Name:TITUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1387 SEATON CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2650
Mailing Address - Country:US
Mailing Address - Phone:614-436-7511
Mailing Address - Fax:
Practice Address - Street 1:1387 SEATON CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2650
Practice Address - Country:US
Practice Address - Phone:614-436-7511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-187358163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2279163Medicaid