Healthcare Provider Details

I. General information

NPI: 1194753137
Provider Name (Legal Business Name): LI-CHUN LIU N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 PARSONS AVE
COLUMBUS OH
43215-5331
US

IV. Provider business mailing address

240 PARSONS AVE
COLUMBUS OH
43215-5331
US

V. Phone/Fax

Practice location:
  • Phone: 614-645-6757
  • Fax: 614-645-0070
Mailing address:
  • Phone: 614-645-7417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP-0485
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: