Provider Demographics
NPI:1811382344
Name:BIEDERMAN, DAVID (FNP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BIEDERMAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2199 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-1303
Mailing Address - Country:US
Mailing Address - Phone:614-551-9236
Mailing Address - Fax:
Practice Address - Street 1:1495 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:OH
Practice Address - Zip Code:43212-2403
Practice Address - Country:US
Practice Address - Phone:614-486-7159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH412477163W00000X, 363LF0000X
OHAPRN.CNP.019537363LP2300X
CA95020066363LP2300X
MI4704347325363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily