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General NPI Number Information
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NPI Number | 1235008319
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Entity Type | Organization
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Legal Business Name | CORNERSTONE EMPOWERMENT AGENCY
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Dates
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Enumeration Date | 11/05/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 5713 WHITE PINE LN
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City | FAIRFIELD TOWNSHIP
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State | OH
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Zip | 45011-4588
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Country | US
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Telephone | 513-345-0729
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Fax |
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Provider Business Mailing Address
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Address Line | 5713 WHITE PINE LN
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City | FAIRFIELD TOWNSHIP
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State | OH
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Zip | 45011-4588
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Country | US
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Telephone | 513-345-0729
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MS. GWENDOLYN BSUGH
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Credential | NAP
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Telephone | 513-345-0729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number |
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License Number State |
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