Healthcare Provider Details

I. General information

NPI: 1316397318
Provider Name (Legal Business Name): BEAUTY MWEMEZI PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2016
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 N HIGH ST
COLUMBUS OH
43201-2460
US

IV. Provider business mailing address

1301 N HIGH ST
COLUMBUS OH
43201-2460
US

V. Phone/Fax

Practice location:
  • Phone: 614-299-6600
  • Fax: 614-421-3111
Mailing address:
  • Phone: 614-299-6600
  • Fax: 614-421-3111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN.395525
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRNNP0032242
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: