Provider Demographics
NPI:1235218272
Name:MERCY HEALTH - ANDERSON HOSPITAL LLC
Entity Type:Organization
Organization Name:MERCY HEALTH - ANDERSON HOSPITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEONATAL NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:TISDALE
Authorized Official - Suffix:
Authorized Official - Credentials:RNC, MSN, NNP
Authorized Official - Phone:513-624-5422
Mailing Address - Street 1:7500 STATE RD
Mailing Address - Street 2:SCN/FBC
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-2439
Mailing Address - Country:US
Mailing Address - Phone:513-624-5422
Mailing Address - Fax:
Practice Address - Street 1:7500 STATE RD
Practice Address - Street 2:SCN/FBC
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-2439
Practice Address - Country:US
Practice Address - Phone:513-624-5422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-08191282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access