Provider Demographics
NPI:1184940561
Name:BILLITER, KORY ELIZABETH (ACNP-BC)
Entity type:Individual
Prefix:
First Name:KORY
Middle Name:ELIZABETH
Last Name:BILLITER
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:KORY
Other - Middle Name:ELIZABETH
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNP-BC
Mailing Address - Street 1:237 WILLIAM HOWARD TAFT RD
Mailing Address - Street 2:2ND FLOOR, CBO 2-3
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2610
Mailing Address - Country:US
Mailing Address - Phone:513-206-1170
Mailing Address - Fax:513-206-1172
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-206-1170
Practice Address - Fax:513-206-1172
Is Sole Proprietor?:No
Enumeration Date:2010-04-11
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.11412-NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3083452Medicaid
OHNP36601Medicare PIN