Organization
BLACK OLIVE HEALTH CARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDEISHA BROOKS FNP-C (APRN)
(419) 295-8811
Entity
Organization
Contact information
Practice address
1415 E DUBLIN GRANVILLE RD STE 100C, COLUMBUS, OH 43229-3311
(614) 943-3776
(860) 261-0210
Mailing address
860 OAKLAND PARK AVE, COLUMBUS, OH 43224-3258
(419) 295-8811
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/17/2022
Last updated
03/16/2026
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