Healthcare Provider Details

I. General information

NPI: 1538848239
Provider Name (Legal Business Name): NATHANIEL STETLER ACNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 07/12/2023
Certification Date: 12/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 VINE ST
CINCINNATI OH
45220-2213
US

IV. Provider business mailing address

7780 BLOME RD
CINCINNATI OH
45243-1304
US

V. Phone/Fax

Practice location:
  • Phone: 513-861-3100
  • Fax:
Mailing address:
  • Phone: 520-904-3059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberAPRN.CNP.0028725
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: