Healthcare Provider Details

I. General information

NPI: 1326369620
Provider Name (Legal Business Name): AMY MARIE MEADE RN, ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 07/07/2020
Certification Date: 07/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 OLENTANGY RIVER RD SUITE 4330
COLUMBUS OH
43214-3937
US

IV. Provider business mailing address

3525 OLENTANGY RIVER RD SUITE 4330
COLUMBUS OH
43214-3937
US

V. Phone/Fax

Practice location:
  • Phone: 614-255-6900
  • Fax: 614-255-6901
Mailing address:
  • Phone: 614-255-6900
  • Fax: 614-255-6901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number278701
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCOA.11580-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: