Healthcare Provider Details

I. General information

NPI: 1245529957
Provider Name (Legal Business Name): OBED C. ANYA CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 VINE ST
CINCINNATI OH
45219-2068
US

IV. Provider business mailing address

PO BOX 832
WEST CHESTER OH
45071-0832
US

V. Phone/Fax

Practice location:
  • Phone: 513-861-3100
  • Fax:
Mailing address:
  • Phone: 513-766-2379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.025314
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN. 341675
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: