Healthcare Provider Details

I. General information

NPI: 1316753239
Provider Name (Legal Business Name): NATALIE GUIST PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 W 5TH AVE STE 225
COLUMBUS OH
43204-4899
US

IV. Provider business mailing address

1419 CLUBVIEW BLVD N
COLUMBUS OH
43235-1261
US

V. Phone/Fax

Practice location:
  • Phone: 614-753-9765
  • Fax:
Mailing address:
  • Phone: 614-753-9765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.009182RX
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number50.009182RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: