Individual
MARY ALICE MOMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2121 BETHEL RD STE F, COLUMBUS, OH 43220-1804
(614) 457-3100
(614) 457-3200
Mailing address
2121 BETHEL RD STE F, COLUMBUS, OH 43220-1804
(614) 457-3100
(614) 457-3200
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN.218736-COA1
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2042426
—
OH
Enumeration date
06/29/2006
Last updated
03/10/2020
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