MEDICARE: DIANE ENZWEILER ARNP

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	363L00000X	Nurse Practitioner	3001921	KY
2	363LA2200X	Adult Health Nurse Practitioner	APRN.CNP.04623	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00920131	OTHER	KY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760481113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE ENZWEILER ARNP

Provider Business Mailing Address
First Line	:	3301 MERCY HEALTH BLVD
Second Line	:	125
City	:	CINCINNATI
State	:	OH
Zip	:	45211-1105
Country	:	US
Telephone Number	:	513-215-9200
Fax Number	:	513-215-9259

Provider Business Practice Location Address
First Line	:	3301 MERCY HEALTH BLVD
Second Line	:	125
City	:	CINCINNATI
State	:	OH
Zip	:	45211-1105
Country	:	US
Telephone Number	:	513-215-9200
Fax Number	:	513-215-9259

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	12/05/2016

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Directions to “ DIANE ENZWEILER ARNP” Practice Location

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