Organization
EDEN HR LLC
Active
Other names
Eden Health Restored
Organization subpart
No
Provider details
NPI number
Authorized official
LATAYA DE JESUS FNP (FOUNDER/CEO)
(740) 780-5057
Entity
Organization
Contact information
Practice address
175 S 3RD ST, COLUMBUS, OH 43215-5134
(740) 780-5057
Mailing address
PO BOX 228, VINCENT, OH 45784-0228
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
—
—
163WN1003X
Nutrition Support Registered Nurse
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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