Provider Demographics
NPI:1215543582
Name:AGARAN, ELIEZAR A (CNP)
Entity type:Individual
Prefix:
First Name:ELIEZAR
Middle Name:A
Last Name:AGARAN
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 W GALBRAITH RD STE 190
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-6002
Mailing Address - Country:US
Mailing Address - Phone:513-346-3399
Mailing Address - Fax:513-853-5543
Practice Address - Street 1:740 W GALBRAITH RD STE 190
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-6002
Practice Address - Country:US
Practice Address - Phone:513-346-3399
Practice Address - Fax:513-853-5543
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027551363LA2100X
OH2020012697363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care