Healthcare Provider Details

I. General information

NPI: 1013790286
Provider Name (Legal Business Name): DANIELLE R TUWAMO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

557 CLARK DR
REYNOLDSBURG OH
43068-3727
US

IV. Provider business mailing address

557 CLARK DR
REYNOLDSBURG OH
43068-3727
US

V. Phone/Fax

Practice location:
  • Phone: 614-795-5924
  • Fax:
Mailing address:
  • Phone: 614-795-5924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number0033456
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: