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General NPI Number Information
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NPI Number | 1508275827
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Entity Type | Individual
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Provider Name | CHRISTINA NICHOLINA OTTEN AGPCNP
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Gender | Female
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 07/24/2019
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Provider Practice Location Address
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Address Line | 222 PIEDMONT AVE
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City | CINCINNATI
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State | OH
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Zip | 45219-4231
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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 | 2830 VICTORY PKWY
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City | CINCINNATI
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State | OH
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Zip | 45206-1785
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Country | US
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Telephone | 513-245-3104
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Fax | 513-585-5511
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | COA.16265-NP
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.16265
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License Number State | OH
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