Healthcare Provider Details

I. General information

NPI: 1952870016
Provider Name (Legal Business Name): NURTURE COLUMBUS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2018
Last Update Date: 03/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 S ROOSEVELT AVE
COLUMBUS OH
43209-2541
US

IV. Provider business mailing address

790 S ROOSEVELT AVE
COLUMBUS OH
43209-2541
US

V. Phone/Fax

Practice location:
  • Phone: 614-407-4305
  • Fax: 614-586-9148
Mailing address:
  • Phone: 614-407-4305
  • Fax: 614-586-9148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: JULIE OBERHOLZER
Title or Position: LACTATION CONSULTANT, CO-OWNER
Credential:
Phone: 703-835-1498