Provider Demographics
NPI:1346782687
Name:ROONEY, JUSTIN (RN)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:ROONEY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:340 THOMAS MORE PKWY
Mailing Address - Street 2:SUITE 220, CHAPEL PLACE B
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-5100
Mailing Address - Country:US
Mailing Address - Phone:717-263-5562
Mailing Address - Fax:717-263-1566
Practice Address - Street 1:375 DIXMYTH AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2475
Practice Address - Country:US
Practice Address - Phone:513-862-2432
Practice Address - Fax:513-862-8857
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2016-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHSP251809367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered