Healthcare Provider Details

I. General information

NPI: 1235496399
Provider Name (Legal Business Name): JESSICA MARIE GRECO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA MARIE NELSON MD

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

543 TAYLOR AVE
COLUMBUS OH
43203-1278
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-4837
  • Fax: 614-293-3125
Mailing address:
  • Phone: 614-293-4837
  • Fax: 614-293-3125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35.128880
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number35128880
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: