Provider Demographics
NPI:1871800698
Name:MARHOOVER, RONETTA E (NP)
Entity type:Individual
Prefix:
First Name:RONETTA
Middle Name:E
Last Name:MARHOOVER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RONETTA
Other - Middle Name:E
Other - Last Name:MARHOOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:1052 S WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891
Mailing Address - Country:US
Mailing Address - Phone:419-238-7777
Mailing Address - Fax:419-238-7979
Practice Address - Street 1:2410 ATHERHOLT RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2148
Practice Address - Country:US
Practice Address - Phone:434-200-5252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003435A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201000900Medicaid
INM400036217Medicare PIN