Basic Information
| Provider Information | |||||||||
| NPI: | 1235711193 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANSARI | ||||||||
| FirstName: | ELIZABETH | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 635283 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452635283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593445555 | ||||||||
| FaxNumber: | 8593445552 | ||||||||
| Practice Location | |||||||||
| Address1: | 4030 SMITH RD STE 350 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452091969 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137914440 | ||||||||
| FaxNumber: | 5139856615 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2021 | ||||||||
| LastUpdateDate: | 06/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | APRN.CNP.0028515 | OH | N | Allopathic & Osteopathic Physicians | Plastic Surgery | 208200000X | RN.415011 | OH | N | Allopathic & Osteopathic Physicians | Plastic Surgery | 363L00000X | 3015434 | KY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 208200000X | 3015434 | KY | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.