Provider Demographics
NPI:1942816053
Name:RAMBO, NONA MARIA
Entity type:Individual
Prefix:
First Name:NONA
Middle Name:MARIA
Last Name:RAMBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3816 EDWARDS ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:MINERAL RIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:44440-9503
Mailing Address - Country:US
Mailing Address - Phone:330-727-3348
Mailing Address - Fax:
Practice Address - Street 1:3816 EDWARDS ST UNIT B
Practice Address - Street 2:
Practice Address - City:MINERAL RIDGE
Practice Address - State:OH
Practice Address - Zip Code:44440-9503
Practice Address - Country:US
Practice Address - Phone:330-980-3397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401618480314374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0349130Medicaid