Healthcare Provider Details

I. General information

NPI: 1154711711
Provider Name (Legal Business Name): BRIAN KAPFUNDE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2015
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2365 INNIS RD
COLUMBUS OH
43224-3730
US

IV. Provider business mailing address

5000 E MAIN ST
COLUMBUS OH
43213-2440
US

V. Phone/Fax

Practice location:
  • Phone: 614-235-5555
  • Fax:
Mailing address:
  • Phone: 614-235-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2291907
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0029419
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: