MEDICARE: MR. OBED C. ANYA 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	163W00000X	Registered Nurse	RN. 341675	OH
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.025314	OH

General Provider Information

NPI Number	:	1245529957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. OBED C. ANYA CNP

Provider Business Mailing Address
First Line	:	PO BOX 832
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45071-0832
Country	:	US
Telephone Number	:	513-766-2379
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 VINE ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2068
Country	:	US
Telephone Number	:	513-861-3100
Fax Number	:

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

Provider Enumeration Date	:	04/04/2011
Last Update Date	:	07/30/2020

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