MEDICARE: AUDREY ELEANOR FIELD 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	478863	OH
2	363L00000X	Nurse Practitioner	APRN.CNP.0038723	OH

General Provider Information

NPI Number	:	1871366369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUDREY ELEANOR FIELD CNP

Provider Business Mailing Address
First Line	:	11333 CORNELL PARK DR STE 200
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45242-1813
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11333 CORNELL PARK DR STE 200
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45242-1813
Country	:	US
Telephone Number	:	513-794-5600
Fax Number	:

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

Provider Enumeration Date	:	11/06/2023
Last Update Date	:	03/04/2025

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