MEDICARE: RABAR NANAKALIY

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	163WM0705X	Medical-Surgical Registered Nurse	RN.543070	OH
2	363L00000X	Nurse Practitioner	APRN.CNP.0042284	OH

General Provider Information

NPI Number	:	1417802828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RABAR NANAKALIY

Provider Business Mailing Address
First Line	:	700 ACKERMAN RD STE 2120
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43202-1559
Country	:	US
Telephone Number	:	614-293-4925
Fax Number	:	614-293-5503

Provider Business Practice Location Address
First Line	:	460 W 10TH AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43210-1240
Country	:	US
Telephone Number	:	614-293-4925
Fax Number	:	614-293-5503

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	06/16/2026

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Directions to “ RABAR NANAKALIY ” Practice Location

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