Healthcare Provider Details

I. General information

NPI: 1013297340
Provider Name (Legal Business Name): UC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST ML 665X
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

234 GOODMAN ST ML 665X
CINCINNATI OH
45219-2364
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-7425
  • Fax: 513-584-8730
Mailing address:
  • Phone: 513-584-7425
  • Fax: 513-584-8730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberCOA 12549-NP
License Number StateOH

VIII. Authorized Official

Name: MS. JINDA AK BOWERMAN
Title or Position: NURSE PRACTITIONER
Credential: NP-C
Phone: 513-584-7425