Healthcare Provider Details

I. General information

NPI: 1275902207
Provider Name (Legal Business Name): JOSHUA TODD BORDNER CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2015
Last Update Date: 07/05/2022
Certification Date: 07/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 OLENTANGY RIVER RD
COLUMBUS OH
43214-3912
US

IV. Provider business mailing address

PO BOX 7527
DUBLIN OH
43017-0727
US

V. Phone/Fax

Practice location:
  • Phone: 614-788-5200
  • Fax: 614-788-5210
Mailing address:
  • Phone: 614-788-5200
  • Fax: 614-788-5210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18132-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: