Healthcare Provider Details

I. General information

NPI: 1972803211
Provider Name (Legal Business Name): EILEEN RENEE FAULDS APRNCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EILEEN RENEE NOBLE CNP

II. Dates (important events)

Enumeration Date: 11/02/2010
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 W 10TH AVE
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-685-3333
  • Fax: 614-685-3335
Mailing address:
  • Phone: 614-685-3333
  • Fax: 614-685-3335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.11910
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: