Healthcare Provider Details

I. General information

NPI: 1568887925
Provider Name (Legal Business Name): JANICE ANN CARROZZELLA MSN, RN, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2014
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10475 MONTGOMERY RD
CINCINNATI OH
45242-5201
US

IV. Provider business mailing address

431 CHESTNUT ST
CINCINNATI OH
45203-1418
US

V. Phone/Fax

Practice location:
  • Phone: 513-865-1690
  • Fax: 513-852-8525
Mailing address:
  • Phone: 513-352-0847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCOA.15013-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: