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General NPI Number Information
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NPI Number | 1073279030
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Entity Type | Individual
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Provider Name | CARLY ESTRELLA ROURKE AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/15/2021
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 7675 WELLNESS WAY
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City | WEST CHESTER
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State | OH
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Zip | 45069-2509
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Country | US
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Telephone | 513-475-8521
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Fax | 513-475-7480
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Provider Business Mailing Address
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Address Line | 5369 MARINERS WAY
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City | LIBERTY TWP
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State | OH
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Zip | 45011-2809
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Country | US
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Telephone | 513-903-0341
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN.CNP.0029781
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License Number State | OH
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