Healthcare Provider Details

I. General information

NPI: 1649815713
Provider Name (Legal Business Name): ANDREW ALLAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2019
Last Update Date: 01/02/2020
Certification Date: 01/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 AUBURN AVE
CINCINNATI OH
45219-2989
US

IV. Provider business mailing address

1923 MILLS AVE
NORWOOD OH
45212-3023
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-2000
  • Fax:
Mailing address:
  • Phone: 513-585-4157
  • Fax: 513-585-4244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.025945
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.025945
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: