Healthcare Provider Details

I. General information

NPI: 1801220470
Provider Name (Legal Business Name): MICHELLE EMILY RUSZKIEWICZ CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2013
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 OLENTANGY RIVER RD STE 6350
COLUMBUS OH
43214-3962
US

IV. Provider business mailing address

3525 OLENTANGY RIVER RD STE 6350
COLUMBUS OH
43214-3962
US

V. Phone/Fax

Practice location:
  • Phone: 614-734-3347
  • Fax: 614-265-2513
Mailing address:
  • Phone: 614-734-3347
  • Fax: 614-265-2513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number379881
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberCOA.16462-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: