MEDICARE: MS. CAROL JEAN ABBOTT APRN

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	NP05314	OH

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932191681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROL JEAN ABBOTT APRN

Provider Business Mailing Address
First Line	:	5885 HARRISON AVE
Second Line	:	SUITE 3500
City	:	CINCINNATI
State	:	OH
Zip	:	45248-1691
Country	:	US
Telephone Number	:	513-922-9660
Fax Number	:

Provider Business Practice Location Address
First Line	:	5885 HARRISON AVE
Second Line	:	SUITE 3500
City	:	CINCINNATI
State	:	OH
Zip	:	45248-1691
Country	:	US
Telephone Number	:	513-922-9660
Fax Number	:

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	03/15/2017

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