Provider Demographics
NPI:1528402609
Name:TOLEDO, MARIANNE BLACK (RN)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:BLACK
Last Name:TOLEDO
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 1:6162 S WILLOW DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-5113
Mailing Address - Country:US
Mailing Address - Phone:303-220-9200
Mailing Address - Fax:
Practice Address - Street 1:6162 S WILLOW DR
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-5113
Practice Address - Country:US
Practice Address - Phone:303-220-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA803123163W00000X
CO1632706163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse