MEDICARE: ANISHA JANARDHANAN NP

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	020286	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	020286	OTHER	OH	APRN LICENSE

General Provider Information

NPI Number	:	1396195202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANISHA JANARDHANAN NP

Provider Business Mailing Address
First Line	:	4685 FOREST AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-3397
Country	:	US
Telephone Number	:	513-246-1964
Fax Number	:

Provider Business Practice Location Address
First Line	:	3055 HAMILTON MASON RD
Second Line	:
City	:	FAIRFIELD TOWNSHIP
State	:	OH
Zip	:	45011-5307
Country	:	US
Telephone Number	:	513-454-3050
Fax Number	:

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

Provider Enumeration Date	:	06/21/2016
Last Update Date	:	06/08/2022

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