Provider Demographics
NPI:1982166229
Name:GARVIN, ANNE (NP-C)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:GARVIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7736 GLEN EDEN LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-3252
Mailing Address - Country:US
Mailing Address - Phone:513-967-2802
Mailing Address - Fax:
Practice Address - Street 1:10506 MONTGOMERY RD STE 300A
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4400
Practice Address - Country:US
Practice Address - Phone:513-246-2400
Practice Address - Fax:513-246-4050
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH023485363L00000X
OHCNP.023485363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2565399Medicaid