Healthcare Provider Details

I. General information

NPI: 1265049209
Provider Name (Legal Business Name): AYAT MUSTAFA ALJAWAWDEH DNP, APRN-CNP, ACNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 03/10/2022
Certification Date: 02/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MOUNT CARMEL HEART & VASCULAR SPECIALIST 85 MCNAUGHTEN RD.
COLUMBUS OH
43213
US

IV. Provider business mailing address

5072 VININGTON PL
DUBLIN OH
43016-8010
US

V. Phone/Fax

Practice location:
  • Phone: 614-627-2000
  • Fax:
Mailing address:
  • Phone: 614-377-3706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.398854
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0028172
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: