Healthcare Provider Details

I. General information

NPI: 1013918028
Provider Name (Legal Business Name): JUDY ROSEMAN PARNES LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1495 MORSE RD
COLUMBUS OH
43229-6478
US

IV. Provider business mailing address

1495 MORSE RD
COLUMBUS OH
43229-6478
US

V. Phone/Fax

Practice location:
  • Phone: 614-267-7003
  • Fax: 614-267-7013
Mailing address:
  • Phone: 614-267-7003
  • Fax: 614-267-7013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberI-549
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: