Healthcare Provider Details

I. General information

NPI: 1902798499
Provider Name (Legal Business Name): CHANA SHAINA ROSENBLUM MSN, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHANA SHAINA KALMANSON

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 VINE ST
CINCINNATI OH
45220-2213
US

IV. Provider business mailing address

3200 VINE ST
CINCINNATI OH
45220-2213
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.0039582
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN.CNP.0039582
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: