Healthcare Provider Details
I. General information
NPI: 1982695821
Provider Name (Legal Business Name): TWILA D PIKE CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/31/2005
Last Update Date: 01/25/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3545 OLENTANGY RIVER RD STE 220
COLUMBUS OH
43214-3907
US
IV. Provider business mailing address
5450 FRANTZ RD STE 360
DUBLIN OH
43016-4141
US
V. Phone/Fax
- Phone: 614-566-4924
- Fax: 614-566-6636
- Phone: 614-544-6155
- Fax: 614-544-5370
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SP0809X |
| Taxonomy | Adult Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | APRN.CNS.01981 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: