Provider Demographics
NPI:1467702332
Name:PISUT, EMILY LOUISE (CNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:LOUISE
Last Name:PISUT
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 OLENTANGY RIVER RD STE 4000
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3154
Mailing Address - Country:US
Mailing Address - Phone:614-366-3934
Mailing Address - Fax:614-366-8469
Practice Address - Street 1:915 OLENTANGY RIVER RD STE 4000
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212
Practice Address - Country:US
Practice Address - Phone:614-366-3934
Practice Address - Fax:614-366-8469
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.369853, 13814-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH157551Medicare PIN