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General NPI Number Information
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NPI Number | 1992419303
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Entity Type | Organization
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Legal Business Name | MIDOHIO FIRST ASSISTING
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Dates
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Enumeration Date | 01/10/2023
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 3535 OLENTANGY RIVER RD
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City | COLUMBUS
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State | OH
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Zip | 43214-3908
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Country | US
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Telephone | 614-361-6994
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Fax |
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Provider Business Mailing Address
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Address Line | 140 BRIARBEND CT
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City | POWELL
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State | OH
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Zip | 43065-8907
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Country | US
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Telephone | 614-580-8607
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | EMILY PETRICK GONZALEZ
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Credential | AGACNP, RNFA
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Telephone | 614-361-6996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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