Basic Information
| Provider Information | |||||||||
| NPI: | 1225476641 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BATLIVALA | ||||||||
| FirstName: | CARLA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | MSN, CPNP-AC | ||||||||
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| Mailing Information | |||||||||
| Address1: | CARDIOLOGY | ||||||||
| Address2: | 3333 BURNET AVE. - ML 2003 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452293026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136364432 | ||||||||
| FaxNumber: | 5136363952 | ||||||||
| Practice Location | |||||||||
| Address1: | CARDIOLOGY | ||||||||
| Address2: | 3333 BURNET AVE. - ML 2003 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452293026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136364432 | ||||||||
| FaxNumber: | 5136363952 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2013 | ||||||||
| LastUpdateDate: | 08/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0200X | 2263536 | MA | N | Nursing Service Providers | Registered Nurse | Pediatrics | 163WP0200X | 618437 | PA | N | Nursing Service Providers | Registered Nurse | Pediatrics | 163WP0200X | L1-0039891 | DE | N | Nursing Service Providers | Registered Nurse | Pediatrics | 363LP0222X | 893959 | MS | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics, Critical Care | 363L00000X | APRN.CNP.022720 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 09683029 | 05 | MS | MEDICAID | 157896 | 05 | AL | MEDICAID |