MEDICARE: BROOKLYN HILL 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	363LA2200X	Adult Health Nurse Practitioner	APRN.CNP.022575	OH

General Provider Information

NPI Number	:	1992290365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKLYN HILL CNP

Provider Business Mailing Address
First Line	:	1275 SCITUATE CT
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-3220
Country	:	US
Telephone Number	:	614-582-1624
Fax Number	:

Provider Business Practice Location Address
First Line	:	477 COOPER RD
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-8053
Country	:	US
Telephone Number	:	614-627-2000
Fax Number	:

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

Provider Enumeration Date	:	06/27/2018
Last Update Date	:	04/15/2022

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