Healthcare Provider Details

I. General information

NPI: 1902054539
Provider Name (Legal Business Name): RENEE SLOBODZIAN NISTHAUZ MS, RNC, NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR NNP OFFICE
COLUMBUS OH
43205-2664
US

IV. Provider business mailing address

700 CHILDRENS DR NNP OFFICE
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-6510
  • Fax: 614-722-4772
Mailing address:
  • Phone: 614-722-6510
  • Fax: 614-722-4772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAPRN.CNP.10219
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: