Organization
PROFESSIONAL PROVIDERS NETWORKING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH A. WADEI APRN FNP-BC, FNP-C (FAMILY NURSE PRACTITIONER)
(614) 574-1823
Entity
Organization
Contact information
Practice address
7602 SLATE RIDGE BLVD, REYNOLDSBURG, OH 43068-8157
(614) 574-1824
Mailing address
691 E DUBLIN GRANVILLE RD, COLUMBUS, OH 43229-3209
(614) 599-2479
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN.CNP.0028939
MEDICARE
OH
05
—
APRN.CNP.0028939
—
OH
Enumeration date
10/15/2021
Last updated
10/30/2024
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