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NPI Code Detail

MEDICARE: ANDREW DOUGLAS HUNTOON RN; PMHNP-BC

MEDICARE: ANDREW DOUGLAS HUNTOON RN; PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0808XPsychiatric/Mental Health Registered NurseRN.423955OH
2363L00000XNurse Practitioner5023787NC
3363L00000XNurse PractitionerAPRN.CNP.0031231OH

General Provider Information

NPI Number : 1174269591
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW DOUGLAS HUNTOON RN; PMHNP-BC
Provider Business Mailing Address
First Line : 3333 BURNET AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-3026
Country : US
Telephone Number : 513-636-0800
Fax Number : 513-636-0835
Provider Business Practice Location Address
First Line : 3333 BURNET AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-3026
Country : US
Telephone Number : 513-636-0800
Fax Number : 513-636-0835
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2022
Last Update Date : 04/17/2026

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