Provider Demographics
NPI:1245478809
Name:CORONA, MARIE ANTOINTTE (LPN)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:ANTOINTTE
Last Name:CORONA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3260 VALERIE ARMS DRIVE
Mailing Address - Street 2:506
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405
Mailing Address - Country:US
Mailing Address - Phone:937-723-6257
Mailing Address - Fax:
Practice Address - Street 1:3260 VALERIE ARMS DR
Practice Address - Street 2:506
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-2113
Practice Address - Country:US
Practice Address - Phone:937-723-6257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 131517164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse