Healthcare Provider Details

I. General information

NPI: 1588063382
Provider Name (Legal Business Name): AMY JALBUENA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2014
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

IV. Provider business mailing address

3173 STRATHBURN CT
DUBLIN OH
43017-1804
US

V. Phone/Fax

Practice location:
  • Phone: 161-472-2200
  • Fax:
Mailing address:
  • Phone: 614-832-0560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAPRN.CNP.16418
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberAPRN.CNP.16418
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: