Healthcare Provider Details

I. General information

NPI: 1225476641
Provider Name (Legal Business Name): CARLA MARIE BATLIVALA MSN, CPNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARDIOLOGY 3333 BURNET AVE. - ML 2003
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

CARDIOLOGY 3333 BURNET AVE. - ML 2003
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4432
  • Fax: 513-636-3952
Mailing address:
  • Phone: 513-636-4432
  • Fax: 513-636-3952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number2263536
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number618437
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberL1-0039891
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number893959
License Number StateMS
# 5
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.022720
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: