Healthcare Provider Details

I. General information

NPI: 1295797496
Provider Name (Legal Business Name): KRISTEN D ANDERSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN D GIRARDI

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 01/25/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 CHATHAM LN
COLUMBUS OH
43221-2417
US

IV. Provider business mailing address

5350 FRANTZ RD
DUBLIN OH
43016-4259
US

V. Phone/Fax

Practice location:
  • Phone: 614-533-5500
  • Fax: 614-533-5593
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number50-001317
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: