Healthcare Provider Details

I. General information

NPI: 1487950531
Provider Name (Legal Business Name): GINA FORSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2011
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2258 WOODSTOCK RD
COLUMBUS OH
43221-1844
US

IV. Provider business mailing address

2258 WOODSTOCK RD
COLUMBUS OH
43221-1844
US

V. Phone/Fax

Practice location:
  • Phone: 614-314-4882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number964788
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: