Healthcare Provider Details

I. General information

NPI: 1235657958
Provider Name (Legal Business Name): ELIE ALBERTINI AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 W GAY ST
COLUMBUS OH
43215-2811
US

IV. Provider business mailing address

2810 FAREHAM CT
COLUMBUS OH
43232-5325
US

V. Phone/Fax

Practice location:
  • Phone: 614-686-3627
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.021377
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.021377
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN.CNP.021377
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: