Healthcare Provider Details

I. General information

NPI: 1457283376
Provider Name (Legal Business Name): GRETA GILBERT MATHURIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6555 BUSCH BLVD STE 260
COLUMBUS OH
43229-1766
US

IV. Provider business mailing address

6555 BUSCH BLVD STE 260
COLUMBUS OH
43229-1766
US

V. Phone/Fax

Practice location:
  • Phone: 614-599-1818
  • Fax:
Mailing address:
  • Phone: 614-599-1818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0042309
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: