Healthcare Provider Details

I. General information

NPI: 1134046790
Provider Name (Legal Business Name): NIMCO HASSAN OMAR MSN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 E MAIN ST
COLUMBUS OH
43213-2440
US

IV. Provider business mailing address

5000 E MAIN ST
COLUMBUS OH
43213-2440
US

V. Phone/Fax

Practice location:
  • Phone: 614-235-5555
  • Fax: 614-536-1994
Mailing address:
  • Phone: 614-235-5555
  • Fax: 614-536-1994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0041088
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: