Healthcare Provider Details

I. General information

NPI: 1366970550
Provider Name (Legal Business Name): KATHRYN ANN VIGLIETTA CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2017
Last Update Date: 01/25/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 OLENTANGY RIVER RD STE 100
COLUMBUS OH
43214-3467
US

IV. Provider business mailing address

5400 FRANTZ RD STE 250
DUBLIN OH
43016-6102
US

V. Phone/Fax

Practice location:
  • Phone: 614-262-6772
  • Fax: 614-533-0162
Mailing address:
  • Phone: 614-544-6382
  • Fax: 614-544-6370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number020879
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: