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General NPI Number Information
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NPI Number | 1275962292
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Entity Type | Individual
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Provider Name | MICHELLE MAYER GOETZ RN, CNP
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Gender | Female
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 3333 BURNET AVE ML 1019 A4N
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City | CINCINNATI
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State | OH
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Zip | 45229-3026
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Country | US
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Telephone | 513-803-9298
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 BURNET AVE
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City | CINCINNATI
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State | OH
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Zip | 45229-3026
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Country | US
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Telephone | 513-803-0456
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | COA.15052-NP
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License Number State | OH
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