=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578240479
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COLUMBIA SCHOOL OF NURSING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/03/2023
-----------------------------------------------------
Last Update Date | 07/03/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 560 W 168TH ST
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10032-3917
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-305-4318
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 104 PEARSALL DR APT 1E
-----------------------------------------------------
City | MOUNT VERNON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10552-3901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-524-5198
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROGRAM DIRECTOR, NURSE ANESTHESIA
-----------------------------------------------------
Name | DR. MERIBETH MASSIE
-----------------------------------------------------
Credential | PHD, MS, BSN, CRNA,
-----------------------------------------------------
Telephone | 212-305-4318
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282NC0060X
-----------------------------------------------------
Taxonomy Name | Critical Access Hospital
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------