Healthcare Provider Details

I. General information

NPI: 1821662784
Provider Name (Legal Business Name): KATHERINE GIA TA-MCINTYRE APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2021
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 OLENTANGY RIVER RD FL 1
COLUMBUS OH
43212-3117
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-688-7040
  • Fax: 614-293-0067
Mailing address:
  • Phone: 614-688-7040
  • Fax: 614-293-0067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0029319
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN.CNP.0029319
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: