Healthcare Provider Details

I. General information

NPI: 1477297455
Provider Name (Legal Business Name): MRS. REBECCA JEAN SCHARTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 OLENTANGY RIVER RD STE 1080
COLUMBUS OH
43214-3984
US

IV. Provider business mailing address

1333 DURNESS CT
COLUMBUS OH
43235-2191
US

V. Phone/Fax

Practice location:
  • Phone: 614-268-8164
  • Fax: 614-268-8406
Mailing address:
  • Phone: 614-282-7092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0031843
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number402554
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: