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General NPI Number Information
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NPI Number | 1114302502
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Entity Type | Individual
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Provider Name | NATHAN ANDREW ROSS FNP
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Gender | Male
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 1204 N COURT ST
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City | CIRCLEVILLE
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State | OH
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Zip | 43113-1000
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Country | US
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Telephone | 740-497-4693
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Fax |
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Provider Business Mailing Address
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Address Line | 114 MADISON AVE
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City | PIKETON
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State | OH
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Zip | 45661-8073
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Country | US
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Telephone | 740-977-9050
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | COA.17398-NP
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License Number State | OH
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