MEDICARE: MR. ALEC SEAN BISAHA 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	363LF0000X	Family Nurse Practitioner	RN.326078-1	OH
2	363LF0000X	Family Nurse Practitioner	COA.17363-NP	OH

General Provider Information

NPI Number	:	1932582202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALEC SEAN BISAHA CNP

Provider Business Mailing Address
First Line	:	1955 HENDERSON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-2401
Country	:	US
Telephone Number	:	614-340-7546
Fax Number	:

Provider Business Practice Location Address
First Line	:	1955 HENDERSON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-2401
Country	:	US
Telephone Number	:	614-340-7546
Fax Number	:

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

Provider Enumeration Date	:	07/06/2015
Last Update Date	:	03/18/2025

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