Provider Demographics
NPI:1225476641
Name:BATLIVALA, CARLA MARIE (MSN, CPNP-AC)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:MARIE
Last Name:BATLIVALA
Suffix:
Gender:F
Credentials:MSN, CPNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARDIOLOGY
Mailing Address - Street 2:3333 BURNET AVE. - ML 2003
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4432
Mailing Address - Fax:513-636-3952
Practice Address - Street 1:CARDIOLOGY
Practice Address - Street 2:3333 BURNET AVE. - ML 2003
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4432
Practice Address - Fax:513-636-3952
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2263536163WP0200X
PA618437163WP0200X
DEL1-0039891163WP0200X
MS893959363LP0222X
OHAPRN.CNP.022720363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09683029Medicaid
AL157896Medicaid
AL157896Medicaid