Healthcare Provider Details

I. General information

NPI: 1316725617
Provider Name (Legal Business Name): FARDOWSA OMAR SHEIKH PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8719 EDGERTON DR
POWELL OH
43065
US

IV. Provider business mailing address

2783 MARTIN RD STE 205
DUBLIN OH
43017-2096
US

V. Phone/Fax

Practice location:
  • Phone: 614-843-9945
  • Fax:
Mailing address:
  • Phone: 614-843-9945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0034718
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: