Healthcare Provider Details

I. General information

NPI: 1649822461
Provider Name (Legal Business Name): TRISHA J HALDERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRISHA J HUNT APRN

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6939 COX RD
LIBERTY TOWNSHIP OH
45069-7595
US

IV. Provider business mailing address

237 WILLIAM HOWARD TAFT RD FL 2
CINCINNATI OH
45219-2610
US

V. Phone/Fax

Practice location:
  • Phone: 513-206-1460
  • Fax: 513-206-1479
Mailing address:
  • Phone: 513-263-8570
  • Fax: 513-263-8622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCNP.025010
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCNP.025010
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCNP.025010
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: