Provider Demographics
NPI:1134558489
Name:PACE, THERESE BERNADETTE (CNS-BC)
Entity type:Individual
Prefix:MS
First Name:THERESE
Middle Name:BERNADETTE
Last Name:PACE
Suffix:
Gender:F
Credentials:CNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3152 MEDINA AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-4221
Mailing Address - Country:US
Mailing Address - Phone:614-236-7592
Mailing Address - Fax:
Practice Address - Street 1:3152 MEDINA AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-4221
Practice Address - Country:US
Practice Address - Phone:614-236-7592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNS-13404163WC1600X
OHRN-191022163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical