Provider Demographics
NPI:1013297340
Name:UC HEALTH
Entity Type:Organization
Organization Name:UC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:JINDA
Authorized Official - Middle Name:AK
Authorized Official - Last Name:BOWERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:513-584-7425
Mailing Address - Street 1:234 GOODMAN ST
Mailing Address - Street 2:ML 665X
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2364
Mailing Address - Country:US
Mailing Address - Phone:513-584-7425
Mailing Address - Fax:513-584-8730
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:ML 665X
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2364
Practice Address - Country:US
Practice Address - Phone:513-584-7425
Practice Address - Fax:513-584-8730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA 12549-NP261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care