Provider Demographics
NPI:1427146604
Name:BOBST, ELIZABETH H (CNP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:H
Last Name:BOBST
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:
Other - Last Name:BOBST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3101 BURNET AVENUE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3014
Mailing Address - Country:US
Mailing Address - Phone:513-357-7289
Mailing Address - Fax:513-357-7396
Practice Address - Street 1:1525 ELM STREET
Practice Address - Street 2:
Practice Address - City:CINCINATI
Practice Address - State:OH
Practice Address - Zip Code:45202
Practice Address - Country:US
Practice Address - Phone:513-352-3092
Practice Address - Fax:513-352-1429
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP05716363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2320296Medicaid
05716OtherCTP ND
253908OtherRN
253908OtherRN
P68597Medicare UPIN
B0202331Medicare ID - Type Unspecified