Individual
ELIZABETH A THEADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NNP
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-4654
Mailing address
1678 DOLLIVOR DR, COLUMBUS, OH 43235-1106
(614) 353-3715
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
316344
OH
363LN0000X
Neonatal Nurse Practitioner
Primary
APRN.CNP.12547
OH
363LN0005X
Critical Care Neonatal Nurse Practitioner
APRN.CNP.12547
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0082623
—
OH
Enumeration date
07/05/2011
Last updated
04/25/2025
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