Healthcare Provider Details

I. General information

NPI: 1437696572
Provider Name (Legal Business Name): KIMBERLY A HEUSER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIMBERLY A NOVENA CNP

II. Dates (important events)

Enumeration Date: 01/27/2017
Last Update Date: 04/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 OLENTANGY RIVER RD SUITE 5300
COLUMBUS OH
43214-3937
US

IV. Provider business mailing address

5400 FRANTZ RD SUITE 250
DUBLIN OH
43016-4144
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-3500
  • Fax: 614-533-0150
Mailing address:
  • Phone: 614-533-6553
  • Fax: 614-544-6370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.020453
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: