MEDICARE: SHYLA RENEE KREAGER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	50.007664RX	OH

General Provider Information

NPI Number	:	1275263949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHYLA RENEE KREAGER PA-C

Provider Business Mailing Address
First Line	:	700 ACKERMAN RD STE 2120
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43202-1559
Country	:	US
Telephone Number	:	614-293-8566
Fax Number	:	614-293-3381

Provider Business Practice Location Address
First Line	:	915 OLENTANGY RIVER RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-3153
Country	:	US
Telephone Number	:	614-293-8566
Fax Number	:	614-293-3381

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2022
Last Update Date	:	02/02/2026

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