MEDICARE: ANISSA KAY BINGMAN APRN-CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.0029065	OH

General Provider Information

NPI Number	:	1144890302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANISSA KAY BINGMAN APRN-CNP

Provider Business Mailing Address
First Line	:	1827 HARD RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43235-5927
Country	:	US
Telephone Number	:	518-522-5648
Fax Number	:

Provider Business Practice Location Address
First Line	:	2880 STELZER RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-3133
Country	:	US
Telephone Number	:	614-472-2880
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2021
Last Update Date	:	07/12/2021

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