Provider Demographics
NPI:1669473617
Name:GIOVANNELLI, MICHELLE E (APRN-CNP)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:E
Last Name:GIOVANNELLI
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-366-7292
Mailing Address - Fax:614-293-0396
Practice Address - Street 1:2050 KENNY RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-3502
Practice Address - Country:US
Practice Address - Phone:614-293-9981
Practice Address - Fax:614-293-8127
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.05305363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2381999Medicaid
OH2381999Medicaid