Provider Demographics
NPI:1912221235
Name:Y'HISRAEL, MICAIAH D'AMARIAH (RN)
Entity Type:Individual
Prefix:
First Name:MICAIAH
Middle Name:D'AMARIAH
Last Name:Y'HISRAEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BAKER AVE # 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45217-1223
Mailing Address - Country:US
Mailing Address - Phone:513-212-6512
Mailing Address - Fax:
Practice Address - Street 1:51 BAKER AVE # 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45217-1223
Practice Address - Country:US
Practice Address - Phone:513-313-5531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN114664164W00000X
OHRN387854163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse