Provider Demographics
NPI:1548771538
Name:MORO, FATI (RN)
Entity Type:Individual
Prefix:
First Name:FATI
Middle Name:
Last Name:MORO
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 1:5835 TOLL LN APT 1A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1450
Mailing Address - Country:US
Mailing Address - Phone:614-772-4391
Mailing Address - Fax:
Practice Address - Street 1:5835 TOLL LN APT 1A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1450
Practice Address - Country:US
Practice Address - Phone:614-772-4391
Practice Address - Fax:614-772-4391
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN409574163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty