Healthcare Provider Details

I. General information

NPI: 1841017498
Provider Name (Legal Business Name): PATRICIA ANNE RESKO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 NEIL AVE
COLUMBUS OH
43215-7309
US

IV. Provider business mailing address

4773 SAINT ANDREWS DR
GROVE CITY OH
43123-8186
US

V. Phone/Fax

Practice location:
  • Phone: 614-221-7464
  • Fax:
Mailing address:
  • Phone: 614-306-4066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0037622
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: