Healthcare Provider Details

I. General information

NPI: 1326633256
Provider Name (Legal Business Name): REBECCA T FRUSTACI APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2021
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1581 DODD DR FL 1
COLUMBUS OH
43210-1257
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-2101
  • Fax: 614-293-9155
Mailing address:
  • Phone: 614-293-2101
  • Fax: 614-293-9155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0028269
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: