Provider Demographics
NPI:1750687950
Name:DIMUZIO, JUDITH ANN (CNS)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:DIMUZIO
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 BURNET AVE
Mailing Address - Street 2:3 SOUTH
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3019
Mailing Address - Country:US
Mailing Address - Phone:513-475-7400
Mailing Address - Fax:513-475-8201
Practice Address - Street 1:222 PIEDMONT AVE
Practice Address - Street 2:SUITE4300
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-4231
Practice Address - Country:US
Practice Address - Phone:513-475-7400
Practice Address - Fax:513-475-8201
Is Sole Proprietor?:No
Enumeration Date:2011-02-04
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06019-NS364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201013450Medicaid
OH3127048Medicaid
IN201013450Medicaid