Healthcare Provider Details

I. General information

NPI: 1811249584
Provider Name (Legal Business Name): NICHOLE HARTRANFT ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2012
Last Update Date: 05/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

793 W STATE ST
COLUMBUS OH
43222-1551
US

IV. Provider business mailing address

793 W STATE ST
COLUMBUS OH
43222-7038
US

V. Phone/Fax

Practice location:
  • Phone: 614-234-5000
  • Fax:
Mailing address:
  • Phone: 614-234-3671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number13666
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number341977
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: