Healthcare Provider Details

I. General information

NPI: 1306958830
Provider Name (Legal Business Name): MRS. MARY F ABBOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. MARY ROSINI ABBOTT

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 OUTERBELT ST
COLUMBUS OH
43213-1548
US

IV. Provider business mailing address

81 OUTERBELT ST
COLUMBUS OH
43213-1548
US

V. Phone/Fax

Practice location:
  • Phone: 614-759-5075
  • Fax: 614-571-1947
Mailing address:
  • Phone: 614-759-5075
  • Fax: 614-571-1947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCOA10738NP
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.10738
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberCOA10738NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: