Provider Demographics
NPI:1497160105
Name:TOLBERT, DIONA (RN)
Entity Type:Individual
Prefix:
First Name:DIONA
Middle Name:
Last Name:TOLBERT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5842 SHADY COVE LN
Mailing Address - Street 2:
Mailing Address - City:TROTWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45426-2118
Mailing Address - Country:US
Mailing Address - Phone:937-219-9756
Mailing Address - Fax:937-529-4004
Practice Address - Street 1:5842 SHADY COVE LN
Practice Address - Street 2:
Practice Address - City:TROTWOOD
Practice Address - State:OH
Practice Address - Zip Code:45426-2118
Practice Address - Country:US
Practice Address - Phone:937-219-9756
Practice Address - Fax:937-529-4004
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-289303163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse