Healthcare Provider Details

I. General information

NPI: 1235778481
Provider Name (Legal Business Name): TAYA MILLER LEWIS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAYA MILLER KNECHT

II. Dates (important events)

Enumeration Date: 01/04/2020
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7575 5 MILE RD
CINCINNATI OH
45230-4346
US

IV. Provider business mailing address

7875 MONTGOMERY RD
CINCINNATI OH
45236-4344
US

V. Phone/Fax

Practice location:
  • Phone: 513-232-7100
  • Fax: 513-624-1240
Mailing address:
  • Phone: 513-686-3031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number320994
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.026274
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: