Healthcare Provider Details

I. General information

NPI: 1548710205
Provider Name (Legal Business Name): PATRICIA WEISBACH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 10/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3219 CLIFTON AVE SUITE 225
CINCINNATI OH
45220-3027
US

IV. Provider business mailing address

3219 CLIFTON AVE SUITE 225
CINCINNATI OH
45220-3027
US

V. Phone/Fax

Practice location:
  • Phone: 513-862-2853
  • Fax: 513-862-4952
Mailing address:
  • Phone: 513-862-2853
  • Fax: 513-862-4952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberAPRN.CNS.019302
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: