| Provider / Organization | NPI | Date Certified |
|---|---|---|
| RODELISA DOUGLAS | 1134997257 | 2024-06-09 |
Rodelisa Douglas is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1134997257. Registration indicates Rodelisa Douglas is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Entity Type | Individual |
| Provider Name | Rodelisa Douglas CNP |
| Practice Office Address | 6011 GROVEPORT RD GROVEPORT, OH US |
| Practice Office Telephone | 6143434783 |
| Mailing Address | 3549 ALBERTA ST COLUMBUS, OH 432281401 US |
| Business Telephone | 6143814150 |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 0035121
OH |