Healthcare Provider Details

I. General information

NPI: 1376026419
Provider Name (Legal Business Name): GLORIA ANN CHARLIER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2018
Last Update Date: 09/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 MARTIN LUTHER KING DR E
CINCINNATI OH
45219-2581
US

IV. Provider business mailing address

311 MARTIN LUTHER KING DR
CINCINNATI OH
45220
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-5000
  • Fax:
Mailing address:
  • Phone: 513-475-5351
  • Fax: 513-281-2571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.230515
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN230514
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberRN.230514
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN.230514
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: