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General NPI Number Information
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NPI Number | 1669863148
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Entity Type | Individual
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Provider Name | EBONEE EMANUEL WHNP
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Gender | Female
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Dates
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Enumeration Date | 02/05/2015
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 15 MESSIMER DR
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City | NEWARK
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State | OH
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Zip | 43055-1841
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Country | US
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Telephone | 220-564-4677
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Fax | 220-564-4678
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Provider Business Mailing Address
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Address Line | 700 CHILDRENS DR
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City | COLUMBUS
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State | OH
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Zip | 43205-2664
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Country | US
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Telephone | 614-722-6200
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Fax | 614-355-6228
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 389194RN
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 16957NP
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License Number State | OH
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