Basic Information
| Provider Information | |||||||||
| NPI: | 1639542822 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRITCHARD | ||||||||
| FirstName: | ABBY | ||||||||
| MiddleName: | |||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3101 BURNET AVE | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452293014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134062569 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7991 BEECHMONT AVE STE A | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452553191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135285600 | ||||||||
| FaxNumber: | 5135289716 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2015 | ||||||||
| LastUpdateDate: | 10/26/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 1141700 | KY | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 3009951 | KY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 020804 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 3125746 | 05 | OH | MEDICAID | 2565399 | 05 | OH | MEDICAID | 7100397560 | 05 | KY | MEDICAID |