MEDICARE: INA VERIJA 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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.0037019	OH

General Provider Information

NPI Number	:	1992543896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INA VERIJA PMHNP-BC

Provider Business Mailing Address
First Line	:	2054 KENTWELL RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-1906
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20620 JOHN CARROLL BLVD STE 214
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-4540
Country	:	US
Telephone Number	:	440-622-7444
Fax Number	:	216-424-3239

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2024
Last Update Date	:	01/27/2026

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