Healthcare Provider Details

I. General information

NPI: 1538405238
Provider Name (Legal Business Name): VICTORIA GREY APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2012
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 KENNY RD STE 1222
COLUMBUS OH
43221-3502
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-366-6675
  • Fax: 614-366-8166
Mailing address:
  • Phone: 614-366-6675
  • Fax: 614-366-8166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.13863
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: