Healthcare Provider Details

I. General information

NPI: 1609546027
Provider Name (Legal Business Name): BARBARA PAULO PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9049 SPRINGBORO PIKE
MIAMISBURG OH
45342-4418
US

IV. Provider business mailing address

6230 MAYFLOWER AVE
CINCINNATI OH
45237-4810
US

V. Phone/Fax

Practice location:
  • Phone: 937-759-0545
  • Fax:
Mailing address:
  • Phone: 216-409-8560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0029783
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: