Healthcare Provider Details

I. General information

NPI: 1790619021
Provider Name (Legal Business Name): STEPHEN CASWELL LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 INDIANOLA AVE STE 107
COLUMBUS OH
43214-1862
US

IV. Provider business mailing address

1120 FOREST GLEN RD
WESTERVILLE OH
43081-3225
US

V. Phone/Fax

Practice location:
  • Phone: 614-371-2303
  • Fax:
Mailing address:
  • Phone: 614-477-6050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number122735.MEDS
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: