Individual
BENJAMIN DAVID LIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
1501 MADISON RD., CINCINNATI, OH 45206-2223
(513) 354-5200
Mailing address
1501 MADISON RD., CINCINNATI, OH 45206-2223
(513) 354-5200
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
28200219A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.019455
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71004343A
APN PRESCRIPTIVE AUTHORITY
IN
01
—
71004343B
CSR-PRESCRIPTIVE AUTHORITY
IN
01
—
APRN.CNP.019455
CERTIFIED NURSE PRACTITIONER
OH
01
—
CTP.019994
CERTIFICATE TO PRESCRIBE
OH
Enumeration date
02/27/2013
Last updated
03/07/2023
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