Healthcare Provider Details

I. General information

NPI: 1942967302
Provider Name (Legal Business Name): JOSHUA WOOD CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2021
Last Update Date: 12/10/2021
Certification Date: 12/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3113 BELLEVUE AVE STE 4100
CINCINNATI OH
45219-3286
US

IV. Provider business mailing address

PO BOX 636256
CINCINNATI OH
45263-6256
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8990
  • Fax: 513-475-8577
Mailing address:
  • Phone: 513-585-6200
  • Fax: 513-245-3672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0030362
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: