Healthcare Provider Details

I. General information

NPI: 1528509890
Provider Name (Legal Business Name): AMY ELIZABETH HAERING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 03/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5015 BRANT RD
MORROW OH
45152-8952
US

IV. Provider business mailing address

5015 BRANT RD
MORROW OH
45152-8952
US

V. Phone/Fax

Practice location:
  • Phone: 513-803-4471
  • Fax:
Mailing address:
  • Phone: 513-803-4471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMY ELIZABETH HAERING
Title or Position: CLINICAL DIRECTOR
Credential: NP
Phone: 513-803-4471