Healthcare Provider Details

I. General information

NPI: 1861774929
Provider Name (Legal Business Name): CRISTINA CHANDLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2011
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3433 AGLER RD STE 2800
COLUMBUS OH
43219-3389
US

IV. Provider business mailing address

2 MIRANOVA PL FL 5
COLUMBUS OH
43215-5078
US

V. Phone/Fax

Practice location:
  • Phone: 614-645-1600
  • Fax:
Mailing address:
  • Phone: 614-268-8164
  • Fax: 614-268-8406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.12765
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: