Healthcare Provider Details

I. General information

NPI: 1376341941
Provider Name (Legal Business Name): ASHLEY LAUREN NERUSU APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 RIVERSIDE DR STE 618
COLUMBUS OH
43221-4012
US

IV. Provider business mailing address

2025 RIVERSIDE DR STE 618
COLUMBUS OH
43221-4012
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-3333
  • Fax: 614-324-9099
Mailing address:
  • Phone: 614-324-9099
  • Fax: 614-675-9329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number485521
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number00057478
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: