Healthcare Provider Details

I. General information

NPI: 1063917557
Provider Name (Legal Business Name): ERIC REING CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 06/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 OLENTANGY RIVER RD
COLUMBUS OH
43214
US

IV. Provider business mailing address

5151 REED RD STE 225C
COLUMBUS OH
43220-2553
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-4919
  • Fax: 614-566-6693
Mailing address:
  • Phone: 614-884-0641
  • Fax: 614-884-0776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.391139
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.019703
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: