Provider Demographics
NPI:1629326657
Name:DEARMOND, CHARITY NICHOLE
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:NICHOLE
Last Name:DEARMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHARITY
Other - Middle Name:NICHOLE
Other - Last Name:SULFRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:9825 KENWOOD RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-6251
Mailing Address - Country:US
Mailing Address - Phone:513-585-3800
Mailing Address - Fax:513-585-3444
Practice Address - Street 1:2139 AUBURN AVE
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-585-3800
Practice Address - Fax:513-585-3444
Is Sole Proprietor?:No
Enumeration Date:2012-08-23
Last Update Date:2012-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.06773-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner