Healthcare Provider Details

I. General information

NPI: 1750994125
Provider Name (Legal Business Name): SOUMI DEY CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 08/26/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2085 CITYGATE DR
COLUMBUS OH
43219-3656
US

IV. Provider business mailing address

247 FRANKFORT SQ
COLUMBUS OH
43206-1059
US

V. Phone/Fax

Practice location:
  • Phone: 614-300-9100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0027403
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: