Basic Information
| Provider Information | |||||||||
| NPI: | 1396185658 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KURON | ||||||||
| FirstName: | TAMMY | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5700 MONROE ST UNIT 207 | ||||||||
| Address2: | |||||||||
| City: | SYLVANIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435602735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4198428150 | ||||||||
| FaxNumber: | 4194792579 | ||||||||
| Practice Location | |||||||||
| Address1: | 5700 MONROE ST UNIT 207 | ||||||||
| Address2: | |||||||||
| City: | SYLVANIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435602735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4198428150 | ||||||||
| FaxNumber: | 4194792579 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2013 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN276108 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.