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NPI Code Detail

MEDICARE: EMILY ANNE KWEDERIS CPNP-AC

MEDICARE: EMILY ANNE KWEDERIS CPNP-AC
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
1163W00000XRegistered NurseRN.472322OH
2363LP0200XPediatric Nurse PractitionerAPRN.CNP.0042419OH

General Provider Information

NPI Number : 1184576092
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY ANNE KWEDERIS CPNP-AC
Provider Business Mailing Address
First Line : 1577 NEIL AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43210-1216
Country : US
Telephone Number : 614-292-4041
Fax Number :
Provider Business Practice Location Address
First Line : 1577 NEIL AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43210-1216
Country : US
Telephone Number : 614-292-4041
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2026
Last Update Date : 06/17/2026

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