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Organization

MOBILE NP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHANNON CARUSO NP (OWNER)
(513) 560-2904
Entity
Organization

Contact information

Practice address
9996 BAUGHMAN RD, HARRISON, OH 45030-1714
(513) 560-2904
(855) 483-9360
Mailing address
9996 BAUGHMAN RD, HARRISON, OH 45030-1714
(513) 560-2904

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
261QP2300X
Primary Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1366070278
OH
Enumeration date
06/10/2021
Last updated
01/31/2022
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