Healthcare Provider Details

I. General information

NPI: 1932747755
Provider Name (Legal Business Name): KRISTI MARIE OLTORIK CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2019
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 OLENTANGY RIVER RD
COLUMBUS OH
43214-3908
US

IV. Provider business mailing address

5600 WINDRIDGE DRIVE
CINCINNATI OH
45243
US

V. Phone/Fax

Practice location:
  • Phone: 614-884-0641
  • Fax: 614-884-0776
Mailing address:
  • Phone: 614-296-2398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number020020
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: