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General NPI Number Information
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NPI Number | 1568301596
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Entity Type | Organization
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Legal Business Name | 5 STAR HEALTH AND WELLNESS CLINIC LLC
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 2900 KEY PL
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City | COLUMBUS
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State | OH
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Zip | 43207-2660
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Country | US
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Telephone | 281-406-1112
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Fax | 713-583-2081
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Provider Business Mailing Address
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Address Line | 7385 STATE ROUTE 3 UNIT 460
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City | WESTERVILLE
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State | OH
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Zip | 43082-8654
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Country | US
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Telephone | 281-406-1112
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Fax | 713-583-2081
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Authorized Official
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Title or Position | OWNER
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Name | OZZIE AMENDA HAIRSTON
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Credential | DNP,APRN,PMHNP-BC
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Telephone | 281-406-1112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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