Healthcare Provider Details

I. General information

NPI: 1720028681
Provider Name (Legal Business Name): REBECCA LU HUSSEINZADEH RN, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 12/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 JOSEPH E. SANKER BOULEVARD THE UROLOGY CENTER
CINCINNATI OH
45212
US

IV. Provider business mailing address

200 NORTHLAND BOULEVARD OUTPATIENT ANESTHESIA SPECIALIST
CINCINNATI OH
45246
US

V. Phone/Fax

Practice location:
  • Phone: 513-841-7600
  • Fax: 513-841-7601
Mailing address:
  • Phone: 513-204-5696
  • Fax: 877-284-4283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN189163
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: